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A  PUBLIC  HEALTH 
SURVEY  OF  TOPEKA 

Parti 

The  Tofeka  Improvement  Survey 

A  report  by 

FRANZ  SCHNEIDER,  JR. 
Sanitarian 

Department  of  Surveys  and  Exhibits 

Russell  Sage  Foundation 

New  York  City 


To  the 

TOPEKA  IMPROVEMENT  SURVEY 
COMMITTEE 

TOPEKA    -    KANSAS 


May  1914 


(CoUege  of  S^ftysitian^  anb  burgeons; 


Digitized  by  tine  Internet  Arciiive 

in  2010  witin  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/publichealthsurvOOschn 


/^c. 


A  PUBLIC  HEALTH  SURVEY 
OF  TOPEKA 

FPvAXZ  SCHNEIDER,  JR. 

SANITARIAN 

Department  of  Surveys  and  Exhibits 

Russell  Sage  Foundation 

130  East  22nd  Street 

New  York  City 

contents 

PAGE 
I.      LIFE,  DEATH  AND  DISEASE   IN  TOPEKA 

The  Death  Rate 3 

The  Birth   Rate 5 

Ward  Differences 7 

Causes  of   Death 8 

Preventable  Diseases 11 

II.    sanitary  conditions 

Water   Supply 19 

Sewerage  and  Sewage  Disposal 21 

Milk   Supply 28 

Food   Supply 41 

Wells  and   Privies 46 

Other  Sanitary  Problems 

Tuberculosis. 55 

Infant  Mortality 59 

Venereal  Diseases.  . 6  2 

Housing G3 

Refuse  Disposal 64 

Physical  Examination  of  School  Children.  .     67 

III.  THE  CITY  HEALTH   DEPARTMENT 

Organization 71 

Financial  Treatment 72 

Inspection   Service 74 

Control  of  Communicable  Diseases.  .     75 

Records 77 

Summary  of  Deficiencies 77 

Recommendations  for  Improvement 7S 

IV.  SUMMARY  AND  CONCLUSIONS 81 

V.      APPENDICES S8 


FOREWORD 

This  Public  Health  Survey  of  Topeka  is  not  the  product  of  in- 
vestigation by  one  individual  or  by  an  organized  staff  working 
under  the  direction  of  one  individual,  but  is  a  product  of  co- 
operation by  the  public  health  forces  of  the  City  of  Topeka  and 
the  State  of  Kansas.  A  mere  recital  of  the  resources  drawn  on 
is  impressive,  the  list  including  the  State  Board  of  Health,  the  city 
Sanitary  Department,  the  State  University,  the  State  Agricultural 
College,  Washburn  College,  and  the  offices  of  the  State  Hotel  and 
Dairy  Commissioners.  To  the  State  Department  of  Health  the  Sur- 
vey owes  the  investigations  covering  vital  statistics  and  the  food 
supply,  as  well  as  generous  and  valuable  co-operation  in  securing 
milk  and  water  analysis  and  the  investigation  of  the  sewer  system. 
To  the  State  University  the  Survey  is  indebted  for  the  investigation 
of  the  sewerage,  and  for  the  remarkable  feat  of  analyzing  some 
seventeen  hundred  samples  of  water.  The  contribution  of  the  city 
Sanitary  Department  is  likewise  a  substantial  one,  covering  the 
enumeration  of  all  wells  and  privies  in  the  city  and  the  prepara- 
tion of  t^ie  maps  representing  this  material.  The  State  Agricultural 
College  lent  its  energies  to  the  chemical  and  bacteriological  ex- 
amination of  milk;  Washburn  College  to  the  bacteriological  exam- 
ination of  samples  of  ice  cream,  and  the  inspection  of  the  places 
in  which  ice  cream  was  handled;  the  State  Hotel  Commissioner  in- 
spected a  number  of  lodging  houses  and  restaurants;  while  the 
State  Dairy  Commissioner  visited  Topeka  and  went  over  the  dairy 
and  milk   depot  situation. 

Thanks  are  especially  due  Dr.  S.  J.  Crumbine,  secretary  of  the 
State  Board  of  Health,  for  his  constant  interest,  encouragement, 
and  assistance;  to  W.  J.  V.  Deacon  for  his  painstaking  analysis 
of  vital  statistics;  to  City  Commissioner  W.  L  Porter  for  his  ready 
and  cordial  co-operation;  and  to  J.  A.  Ramsey,  sanitary  sergeant. 
Others  in  this  list  are  Prof.  Granville  R.  Jones  of  the  State  Univer- 
sity; Prof.  C.  C.  Young,  director  of  the  State  Water  Survey;  Prof. 
L.  D.  Bushnell  of  the  State  Agricultural  College;  Prof.  Edith  M. 
Twiss  of  Washburn  College;  State  Dairy  Commissioner  George  P. 
Hine;  State  Hotel  Commissioner  Miles  Mulroy;  Mrs.  Charles  B. 
Thomas  and  Miss  Mary  R.  Vose.  What  a  large  part  of  the  work 
was  carried  out  by  these  co-operators  readily  can  be  seen,  and  to 
them  thanks  are  due  for  the  breadth  of  scope  which  it  has  been 
possible  to  give  this  survey. 


A  PUBLIC  HEALTH  SURVEY 
OF  TOPEKA 


I.     LIFE,  DEATH  AND  DISEASE. 

Eight  hundred  and  thirty-five  persons  died  in  Topeica  in 
li^l-2.  giving  the  city  a  death  rate  of  17.'.?'  per  iJJOiJ  cif  tlie 
population  as  against  10.2  for  the  ^tate  of  Kansas  as  a  whole. 
The  question  naturally  arises  why  IS  persons  out  of  each  thou- 
sand should  die  in  Topeka  while  only  ten  die  in  the  whole 
state.  Is  there  an  unusual  and  unnecessary  amotmt  of  sickness 
and  death  in  the  city:  or  is  there  an  unusual  number  of  in- 
fants and  old  persons,  whose  death  rates  are  always  high;  or 
is  it  a  fact  that  the  city's  hospitals  attract  an  unusual  number 
of  non-residents  whose  deaths  go  to  swell  the  city's  i  otal '  Such 
explanations  will  occur  readily  to  natives  of  the  i  ity.  Still 
Topeka  is  a  yoting.  normally-growing  western  city,  such  as  usu- 
ally has  a  low  death  rate,  and  we  must  inquu-e  into  the  facts 
and  see  whether  these  or  other  special  factors  accoimt  for  the 
excessive  rnr>rtality.  or  whether  real  evils  exi>t. 

The  Death  Eate. 

Tile  fir^t  and  mo-t  oljvious  correction  of  tlie  death  rate  is 
that  which  eliminates  deaths  of  non-residents.  In  191l^  To- 
peka's  complete  death  registration  of  So-i  included  171  such 
j^ersons.  Making  the  correspondhig  correction,  the  rate  falls 
to  14.1'  per  1.000 — a  figure  still  40  per  cent  higher  than  that  of 
the  state  as  a  whole. 

Taking  now  the  resident  deaths  in  Topeka  i  and  in  all  cal- 
ctilations  which  follow  only  resident  deaths  will  be  considered) 
and  comparing  the   city's  mortality   at   different   age  grotips 

3 


with  that  of  the  state,  it  is  apparent  that  the  city  is  always  in 
excess.    The  figures  are  shoAvn  below : 


Table  1. 


Death  Eates  by  Age  Groups,  Topeka  vs.  State  of 

Kansas,  1912. 


Age 

Topeka 

State   of   Kan. 

Topeka  excess 

Under  5  years 

33.6 

3.4 

5.1 

7.0 

17.6 

72.1 

20.5 

1.7 

3.2 

5.2 

13.8 

63.8 

13.1 

1.7 
1.9 
1.8 
3.8 
8.3 

5-14    years 

15-24    years 

25-44    years 

45-64    years 

65  and  over 

All 

14.2 

10.2 

4.0 

At  the  same  time  there  is  a  slightly  more  favorable  age 
distribution  of  population  in  the  state;  but  when  proper  cor- 
rection is  applied  ^  the  reduction  in  the  city's  general  death 
rate  is  small — from  14.2  to  13.2.  This  small  reduction  on  ac- 
count of  age  distribution  will  be  surprising  to  many  who  have 
considered  Topeka's  "retired  farmer"  population  as  having  an 
important  influence  on  her  death  rate. 

On^  more  correction  may  be  applied — that  for  color.  To- 
peka has  a  negro  element  in  her  population  of  10.4  per  cent — as 
against  3.2  per  cent  for  the  entire  state ;  and  the  crude  death 
rate  of  these  negroes  was,  in  1912,  22.9  as  against  13.2  for  the 
whites.  This  marked  advantage  of  the  whites  will  be  consid- 
ered again;  for  the  present  it  is  sufficient  to  note  that  a  liberal 
correction  of  the  city's  death  rate  on  this  score  drops  it  from 

13.2  to  12.3,  leaving  it — after  all  corrections — still  20  per  cent 
in  excess  of  the  state  rate. 

Compared  with  the  United  States  Registration  Area 
(about  two-thirds  of  the  country)  Topeka  appears  somewhat 
more  favorably;  the  relative  figures  being,  after  correction 
for  non-residents,  age,  and  sex\  18.1  for  the  Area  as  against 

16.3  for  the  city.  It  must  be  remembered,  however,  that  the 
Registration  Area  includes  the  principal  large  cities  of  the 
country,  and  that  it  would  be  expected  to  have  a  death  rate 
considerably  in  excess  of  a  city  of  Topeka's  character. 

To  sum  up  the  matter,  Topeka  has  a  high  crude  death 
rate,  due  in  considerable  degree  to  the  deaths  of  non-residents. 
Eliminating  these  her  rate  compares  favorably  with  that  of 

1  For  details  see  Appendix  "A". 


^=r 


ii,_ J_'_  Jj_  ^ .  -SU  U12, 


□DDDEG: 


MAP    OF 

CITY  OF  TOPEKA 
TOPEKA  WPRoIkENT  SURVEY 


FIG.  1.     REGISTERED  BIRTHS,  TOPEKA,  1913. 

the  country  as  a  T\'hole.  but  unfavorably  with  that  of  the  State 
of  Kansas.  It  would  appear  that  Topeka  suffers  from  some 
of  the  health  handicaps  incidental  to  city  life :  and  that  while 
the  amount  of  her  disadvantage  is  not  alarming,  it  is  of  suffi- 
cient magnitude  to  demand  a  careful  scrutiny  of  existing  sani- 
tary conditions. 


The  Birth  Rate. 

Over  against  her  664  resident  deaths  occurring  in  1912  To- 
peka can  set  923  births:    giving  a  birth  rate  (or  ratio  of  re- 

5 


The 

Topeka 

Improvement 

Survey 

1913 


3.8-7.5        7.6-I2J       12 .4 -18  J 


I84-2S.7      256- M2     34,3-43.9      4J.9-54.8 


PEE.S0N5-PER.ACEt  or 
PLATTED    AE.E*^. 


MAP  SHOWING  DENSITY  OF  POPULATION,  TOPEKA,   1910. 


ported  births  per  thousand  popidatioii)  of  19.8,  and  a  natural 
rate  of  increase  (excess  of  births  over  deaths)  of  5.6  per  1,000. 
This  birth  rate  is  not  large,  and  the  rate  of  increase  is  but  a 
small  part  of  that  (30  per  1,000)  actuall}^  maintained  through- 
out the  decade  1900-1910.  By  far  the  most  important  source 
of  the  city's  growth  is  evidently  immigration  from  outside. 

The  number  of  births  registered  in  1913  showed  a  falling 
off,  the  rate  dropping  to  17.4  per  1.000.  and  the  comparison  of 
these  figures  with  those  for  the  State  of  Kansas,  given  in 
Table  2,  shows  the  city  at  a  disadvantage.     Topeka's  death 

6 


rate  is  higher,  and  her  birth  rate  lower,  than  that  of  the  whole 
state. 


Table  2.     Birth  Rate,  Topeka  vs.  State  or  Kansas. 


Topeka 

19.8 
17.4 

State   of  Kan. 

Topeka's  Deficiency 

1912 

1913 

22.5 

21.0 

2.7 
3.6 

Wakd  Differences. 

The  distribution  of  births  throughout  the  city  is  indi- 
cated in  Figure  1 ;    that  of  births  and  deaths,  as  expressed  in 


MAP    OF 

CITY  OF  TOPEKA 

TOPEKA  uprnhmrSiiMy 


WARD  MAP  OF  TOPEKA. 

7 


rates,  is  shown  in  Table  3.  The  marked  variations  exhibited 
between  the  wards,  from  7.6  to  19.1  in  the  death  rate  and  from 
10.7  to  26.4  in  the  birth  rate  are  doubtless  a  result,  to  a  large 
degree,  of  differences  in  the  character  of  the  poj)ulation. 
Ward  3,  for  example,  including  some  of  the  best  parts  of 
town,  has  at  once  the  highest  death  rate  and  the  lowest  birth 
rate,  being  the  center,  no  doubt,  of  the  "retired  farmer"  pop- 
ulation. Ward  5,  which  embraces  the  southern  edge  of  the 
city,  has,  on  the  other  hand,  the  combination  of  highest  birth 
and  lowest  death  rate — and  so  may  lay  claim  to  considerable 
hygienic  credit.  Its  rate  of  natural  increase  for  the  year  was 
over  twice  that  of  any  other  ward. 

Table  3.     Ward  Birth  and  Death  Eates,  Topeka,  1912. 


Ward 

Population 

Death  Eate 

Birth  Rate 

Natural  Rate  of  Increase 

1 

6,388 

16.2 

18.8 

2.6 

2 

12,378 

16.1 

21.0 

4.9    ■ 

3 

8,522 

19.1 

10.7 

—8.4 

4 

7,312 

12.0 

17.8 

5.8 

5 

7,611 

7.6 

26.4 

18.8 

8 

4,376 

11.6 

18.5 

6.9 

City... 

46,578 

14.2 

19.8 

5.6 

These  differences,  while  not  accurate  indications  of  ac- 
tual degrees  of  healthfulness,  are  large  enough  to  be  of  some 
real  significance ;  and  reinforce  the  suggestion  of  our  analy- 
sis of  the  general  death  rate,  i.  e. — the  necessity  for  careful 
scrutiny  of  existing  sanitary  conditions. 

Causes  of  Death. 

The  next  test  that  may  be  applied  to  Topeka's  mortality 
statistics  is  the  most  illuminating  of  all:  it  is  the  examina- 
tion of  the  causes  of  death.  Modern  science  recognizes  two 
great  groups  of  diseases :  constitutional  — as  a  naturally  weak 
heart,  or  a  congenial  deformity;  and  infectious — those  pro- 
duced by  external  influences,  and  of  which  typhoid  fever  is  a 
type.  With  the  constitutional  diseases  little  can  be  done,  ex- 
cept as  it  may  be  possible  to  prevent  the  breeding  of  the  un- 
fit; but  great  advances  have  been  made  in  the  last  few  years 
in  our  knowledge  of  the  infectious  diseases  and  here  a  great 
field   for   the   protection   of  health   and  hapj)iness  has  been 


opened  up.  Prominent  among  the  infections  are  the  germ 
diseases — sometimes  referred  to  as  the  communicable  diseases, 
and  including  the  so-called  contagious  diseases;  but  poison- 
ings by  industrial  processes,  or  by  ptomaines,  and  the  like, 
are  included  under  any  liberal  interpretation  of  the  term.  It 
is  with  this  great  group  of  environmentally  produced,  pre- 
ventable deaths  that  we  are  primarily  concerned:  and  it  is 
with  this  point  of  view  that  we  direct  our  attention  to  the 
causes  of  Topeka's  mortality. 

Leadixg  Caitses  of  Death.  Topeka,  1912. 

(Rates  per  100,000  Population.) 


Tuherulosis ^^^^^^^^^9 

Bright's  disease 

Organic  heart  disease ^^^^^^^^^ 

Old  age 

P"^"'"""'^ ^^^^^^g^ 

Broncho  pneumonia p^ypp^pf^M^^^M^^^" 

Paralysis ammtm^^^^^^KK^^m 

Respiratory  diseases  not  specified  . .  ■■■■^^^^^^^^^^■^^B 
Nervous  diseases  not  specified  ...  p^ppppppiflP^^^^^M^ 
Diarrhoea  and   enteritis  under  2 . . ■■■■■■■■■■^^^^^■Ci?^ 

Diseases  of  early  infancy ^^^^^^/'.^^i/;^ 

General   diseases   not   specified  ....  pppppppp^^^^M 

Typhoid  fever ^^^^^^^^^'-^ 

Homocide fm^^^^^^K^^^'? 

Accidents mmmmmtmafu^ ■=- , 

Cerebral  hemorrhage WB^B^zhzz2(.%y 

Circulatory  diseases  not  specified .  ^^^^^^^^rry^u-, 

Appendicitis BHfl^^^^  ^ 

Molformaticns ■^■^^^-^'^ 

^^^''^^^ ^^^^r77-7 //////// rr^ai. 

°''"^*''"'^ ^m^^-s 

Rheumatism ^HH^^^ 

Acute  nephritis wtm^ioi 

Genito-urirary — rot  specified.    ...  pfMi-^°^ 

Peritonitis glBBJo* 

Diseases  of  the  skin j^^Hzo^ 

By 
Diabetes ao , 

Diseases — ill-defined wammmmmm^ 


e^sf 


^^^^H  Negroej- 

v^ '///i  Wf)/fe  perfoipj- 


The  most  striking  feature  of  the  above  chart  is,  of  course, 
the  almost  invariable  excess  of  mortality  among  the  negroes, 
and  the  particular  disproportion  with  respect  to  tuberculosis. 
The  negro's  experience  in  Topeka  is  but  an  illustration  of  a 
general  principle — his  relative  inability  to  cope  with  the 
health  hazards  of  our  city  life.     His  physical  inheritance  is 


such  as  offers  the  least  resistance  to  the  white  man's  city-life 
diseases,  and  his  social  and  economic  position  is  such  that  he 
lacks  most  of  the  white  man's  artificial  defenses.  With  their 
general  death  rate  nearly  twice  that  of  the  white  inhabitants, 
it  is  evident  that  Topeka  needs  make  special  provision  for 
public  health  work  among  her  5,000  negroes. 

Notable  among  the  causes  of  death  among  Topeka's  white 
citizens  are  certain  constitutional  diseases  —  such  as  of  the 
heart  and  kidneys,  regarding  Avhich  little  of  a  directly  pre- 
ventive nature  can  be  done;    and  several  infectious  diseases, 

Table  4.     Preventable  Deaths,  Topeka,  1912. 


Diseases    commonly    regarded 
preventable. 

Deaths 

Rate  per   100,000. 

Tuberculosis  (all  forms) 

47 
25 
16 

9 

3 

2 

1 

1     104 

102.2 
54.4 
34.8 
19.3 

6.5 

4.3 

2.2 

2.2     225.9 

Diarrhoea  and  enteritis  under  2 .  . . 

Typhoid  fever 

Whooping  cough 

Smallpox.  .  .       

Diseases    in    which    factor    of 
preventability  enters. 

Diseases  of  early  infancy 

Pneumonia 

Bronclio  pneumonia 

Accidents 

Puerperal  state 

Meningitis 

Totals 

35 
34 
23 
26 
10 
5     133 

76.2 
73.8 
50.0 
56.5 
21.7 
10.8     289.0 

237 

514.9 

by  far  the  most  prominent  of  which  is  tuberculosis.  Deaths 
from  the  constitutional  diseases  are,  on  the  whole,  the  more 
numerous;  but,  brought  together,  as  in  Table  4,  the  principal 
infections  (and  accidents)  present  no  mean  array. 

Thus  from  diseases  of  unquestionable  preventability  To- 
peka has  suffered,  in  a  single  year,  104  deaths;  and  from  cer- 
tain other  diseases  133  deaths — a  goodly  number  of  which  are 
probabh^  preventable.  Avoidable,  therefore,  were  15.7  per 
cent  of  the  year's  deaths;  with  another  20  per  cent  as  a  po- 
tential premium.  And  these  figures  take  no  account  of  the 
incidental  cases  of  non-fatal  illness  —  probably  ten-fold  in 
number.     No  extended  discussion  is  needed  to  emphasize  the 

10 


importance  of  the  situation :  it  will  probably  be  some  time 
before  Topeka  gets  to  prevent  all  this  mortality,  but  she  can 
hasten  toward  the  goal  if  she  will,  and  much  of  the  wsij  is 
easily  to  be  traveled  if  she  cares  to  adopt  the  accepted  features 
of  a  modern  public  health  program. 

DlSTRIBLTIOX    OF    PREVENTABLE    DISEASES. 

Study  of  the  distribution  of  preventable  diseases  through- 
out a  city  is  not  only  interesting  in  itself,  but  is  profitable 
from  the  standpoint  of  diagnosing  the  situation  and  laying 
WARD    DEATH    EATES    FROM    PREVENTABLE    CAUSES,    TOPEKA.i 


WARDS 

2    3    4    5     6 


WARDS 

2     3    4     5     6 


isTT 


WARDS 

12     3     4.     5     6 


3a7 

1 


TUBERCULOSIS 

(per  lOO.OOo) 


PNEUMONIA 

Cpffr  loo.ooq) 


TYPHOID  FEVE.R- 
(per  ;oo,ooo3 


60i2 
H    51.0 


MA 


4b 

I 


DIPHTHERIA-SCARLFT-FEVLR 
MEASLES -WHOOPING  COUGH 
(per  loo.ooo) 


INFANT   MORTALITY 
Cfier  1000  births') 


DIARR.HOEf\ftMDENTtR\TlS 
(Under  2.)      (per  1 00,000.) 


out  a  program.  Such  a  study  is,  in  Topeka.  unusually  diffi- 
cult, owing  to  the  fact  that  prior  to  1912  only  about  half  the 
deaths  were  registered,  while  prior  to  the  fall  of  1913  no  rec- 
ords at  all  were  made  of  cases  of  contagious  diseases.  These 
unfortunate  and  uncivilized  conditions  are  now  being  reme- 
died— in  the  first  instance  thanks  to  the  state  vital  statistics 

1  For  further  details  see  Appendix  "B"'. 


11 


FIG.  2.     DEATHS  FROM  TUBERCULOSIS,  TOPEKA,   1908-1913. 
(Registration  incomplete) 


law,  in  the  second  to  the  initiative  of  the  present  sanitary  ser- 
geant; but  the  information  on  file  is  lamentably  meagre,  is  in 
some  cases  incomplete,  and  has  to  be  interpreted  with  care. 
Death  records  must  be  relied  on  solely,  and  comparable  pe- 
riods cannot  be  taken  in  every  case. 

The  facts,  as  far  as  they  may  be  obtained  for  the  different 
wards,  are  displayed  in  the  chart  on  page  11;  the  more  precise 
location  of  individual  deaths  being  indicated  in  Figures  2  to 
8,  inclusive.     Ward  3,  for  example,  which  we  have  seen  to 

12 


MAP    OF 

CITY  OF  TOPEKA 
TOPEKA  IMPRCVEMENT  SURVEY 


PIG.   3.      DEATHS  FROM   PNEUMONIA,   TOPEKA,   1910-1913. 
(Registration  incomplete) 

have  the  highest  general  death  rate,  makes,  with  respect  to 
these  preventable  diseases,  a  uniformly  excellent  showing: 
Wards  2  to  6,  on  the  other  hand,  come  off  relatively  badly. 
The  figures  for  typhoid  fever  for  another  thing,  while  based 
on  a  somewhat  small  number  of  instances,  are  of  real  signifi- 
cance, especially  when  taken  in  connection  with  the  facts  re- 
garding wells  and  privies,  which  are  to  be  found  later  in  this 
report.  Again,  the  relative  mortality  from  the  common  con- 
tagious diseases  of  children — diphtheria,  scarlet  fever,  measles, 
and  whooping  cough,  is  entirely  out  of  j)roportion  to  any  pos- 


13 


FIG.  4.  DEATHS  FROM  TYPHOID,  TOPEKA,  1908-191; 

(Registration  incomplete) 

Eacli  death  represents  about   10  non-fatal  cases. 


sible  differences  in  the  number  of  children  in  the  wards;  and 
makes  a  stirring  appeal  for  better  administrative  control. 
Diphtheria  has  been  the  most  deadly  of  these  diseases,  and,  as 
is  clear  from  an  examination  of  Figure  5,  has  centered  in 
North  Topeka  and  the  east  side.  With  each  death  represent- 
ing another  ten  or  twenty  non-fatal  cases,  the  size  of  the  bur- 
den is  more  ajjparent ;  it  is,  in  fact,  entirely  too  great,  and  the 
same  j)rocedures  that  restrict  it  in  Ward  3 — prompt  adminis- 

14 


JUUL 

imm 


MAP    OF 

GITY  OF  TOPEKA 
TOPEKA  IMPi^^ENTSORVet' 


FIG.   0.     DEATHS  FROM  DIPHTHERIA,  TOPEKA,   1908-1913. 
(Registration  incomplete) 
Note  the  marked  localization  in  East  and  Xortli  Topeka.     Each  death  rep- 
resents another  ten  or  twenty  non-fatal  cases. 

tration  of  anti-toxin  and  proper  isolation — ^vill  control  it  in 
Wards  1  and  2. 

Similar  arguments  apply  to  infant  mortality — especially 
that  part  represented  hy  diarrhoea  and  enteritis.  Relatively 
small  expenditures  for  public  health  nurses  hare,  in  other 
cities,  affected  remarkable  results  in  baby  saving:  there  is 
every  reason  to  believe  that  similar  results  vould  be  obtain- 
able in  Topeka.     This  question,  as  well  as  those  particularly 


15 


FIG.   6.     DEATHS  FROM  SMALLPOX,  MEASLES,   SCARLET  FEVER 
AND  WHOOPING  COUGH,  TOPEKA,   19  08-1913. 
(Registration  incomplete) 
Squares  indicate  smallpox 
Solid  circles  indicate  measles 
Stars  indicate  scarlet  fever 
Open  circles  indicate  whooping  cough 
Note  localization  in  eastern  part  of  the  city 

affecting  tuberculosis,  will  be  discussed  later  in  the  present 
report. 

Summary  and  Conclusions. 

In  our  study  of  Topeka's  vital  statistics  we  have  seen  that 
her  death  rate,  while  comparing  favorably  with  that  of  the 


16 


□DDnnaDDDuD}/: 

DOE 


„„JDSC 

]DDonn.HFll 


MAP    OF 

CITY  OF  TOPEKA 
TOPEKA  IMPRC^lMENT  survey 


/.iSOD 


FIG.   7.      INFANT  DEATHS    (UNDER   1),   TOPEKA,    1910-1913 

(Registration  incomplete) 

Compare  with  distribution  of  births  as  indicated  in  Fig.  1. 

country  at  large,  is,  after  applying  the  proper  corrections,  still 
20  per  cent  in  excess  of  that  of  the  state  of  Kansas;  that  her 
birth  rate  is  in  general  somewhat  low,  and  over  a  tenth  lower 
than  the  state's;  that  her  people  suffer  real  losses  from  pre- 
ventable disease  and  death;  and  that  these  diseases  are  espe- 
cially prevalent  in  certain  parts  of  the  city.  The  suggestion 
is  clear  that  there  is  need  for  a  careful  scrutiny  of  existing 
sanitary  conditions,  and  of  the  administrative  measures  of  con- 
trol.    Topeka,  in  short,  has,  like  other  cities,  a  public  health 


17 


FIG   8.      DEATHS  FROM  DIARRHOEA  AND  ENTERITIS,   UNDER   2, 
TOPEKA,   1912-1913. 

Compare  with  distribution  of  births  as  indicated  in  Fig.  1. 

problem;  while  not  alarmingiy  large,  it  is  entirely  definite 
and  real.  That  it  is  of  goodly  proportions,  witness  the  fact 
that  15  and  possibly  30  per  cent  of  the  deaths  in  the  city  are 
from  preventable  diseases. 


II.     SANITARY  CONDITIONS  IN  TOPEKA 

CITY  AVATER  SUPPLY. 

Two  principal  water  .supply  developments  exist  in  Topeka 
— that  of  the  Santa  Fe  Eailroad  and  that  of  the  municipality. 
Both  stipj^lies  are  taken  fi'om  dug  and  driven  wells  located  on 
the  south  bank  of  the  Kansas  river,  and  the  two  systems  hare 
a  connection  which  permits  pumping  from  one  to  the  other  at 
times  of  emergency.  Becatise  of  this  connection,  and  the  cor- 
responding possibility  of  the  distribution  of  Santa  Fe  water 
in  the  city  mains,  both  systems  were  inspected  during  the  Sur- 
vey and  both  waters  were  examined. 

The  municipal  supply  is  obtained  from  48  small  driven 
wells  and  three  large  dug  wells,  all  located  on  the  edge  of  the 
river,  a  short  distance  above  the  city.  The  small  wells,  which 
ordinarily  contribute  about  40  per  cent  of  the  supply,  were 
located  when  driven  in  the  low  land  on  the  bank;  they  are  now, 
owing  to  a  change  in  the  river  bed.  entirely  under  water  at  all 
times.  These  wells  are  from  18  to  36  feet  in  depth,  are  six  to 
eight  inches  in  diameter,  and  are  connected  by  a  suction  line 
to  the  pumps  and  so  directly  with  the  mains  to  the  city. 

The  dug  wells,  contributing  about  CO  per  cent  of  the  stip- 
ply.  are  three  in  nttmber.  two  60  feet  in  diameter  and  one  of 
48  feet.  These  Avells  penetrate  successive  layers  of  sand.  loam, 
blue  clay,  and  quicksand,  and  finally  take  their  water  from  a 
stratum  of  coarse  sand  and  gravel.  The  walls  are  of  brick  to 
the  level  of  the  ground,  are  contiuued  then  in  concrete  to  above 
flootL  level,  finally  supporting  suitable  wooden  roofs.  Enter- 
ing one  of  the  wells  for  inspection,  the  water  was  seen  to  be 
making  its  way  in  under  the  wall  on  the  uphill  side  (that  far- 
thest from  the  river)  :  it  is  pumped,  as  the  case  may  be.  into 
one  of  the  other  wells  or  directly  into  the  mains  to  the  city. 

Both  city  well  systems  seem  to  tap  the  same  water-bear- 
ing stratum,  and  to  secure  water  which  appears  to  be  of  ex- 
cellent   sanitary   quality,   analyses^   made   during  the    Stirvey 

1  A  typical  analvsis  may  be  found  in  Appendix  "C". 

19 


failing  to  disclose  any  trace  whatever  of  pollution.  Accord- 
ingly there  is  reason  to  believe  that  the  city  has  secured  water 
from  the  underflow  water,  which  probabl}^  conies  a  very  con- 
siderable distance,  and  so  is  safe  from  contamination.  The 
city  is  indeed  fortunate  to  secure  such  an  abundant  and  satis- 
factory supply  at  so  little  effort. 

Some  criticism  may  properly  be  made  of  the  older 
(driven)  wells.  Covered  with  river  water  at  all  times,  they 
afford  an  opportunity  for  contamination  from  breaks  in  the 
suction  line.  Such  breaks  are  bound  to  occur,  the  supply  from 
these  wells  being  shut  off  at  the  time  of  the  Survey  for  this 
very  reason.  The  j^roperly  protected  dug  wells  now  in  use  are 
the  more  commendable  type,  and  future  developments  of  the 
suj^ply  should  undoubtedly  take  this  form. 

The  Santa  Fe  supply  is  secured  from  one  dug  well  some 
30  feet  in  diameter  and  12  drilled  wells.  From  data  available 
it  would  appear  that  the  railroad  wells,  though  driven  some- 
what deeper  from  the  surface  than  the  city  wells,  penetrate 
material  of  very  similar  nature,  and  obtain  their  water  from  a 
closely 'analogous  stratum  at  a  depth  which,  when  referred  to 
the  high  water  mark  of  the  1903  flood,  is  very  close  to  that  of 
the  city  wells.  Analysis  of  samples  of  the  Santa  Fe  water 
taken  from  the  dug  well,  the  drilled  wells,  and  a  tap  in  the 
shops,  all  showed  the  water  to  be,  at  the  time,  of  excellent 
sanitary  quality. 

The  connection  between  the  Santa  Fe  and  city  systems  is 
maintained  for  mutual  convenience,  water  being  pumped  oc- 
casionally from  one  system  to  the  other  in  times  of  fire  or 
other  emergency.  While  both  waters  seem  excellent  at  pres- 
ent, it  is  to  the  advantage  of  both  parties  that  careful  and 
regular  analytical  supervision  be  kept  of  both  waters;  and 
that  the  division  valve  be  carefully  protected,  and  that  a  record 
be  kept  of  any  interchanges  of  water. 

In  general,  the  city  will  be  wise  to  adopt  a  liberal  policy 
regarding  the  development  of  its  present  satisfactory  water 
supply.  Pumping  from  the  river,  such  as  was  resorted  to  in 
1910,  should  never  be  found  necessary — a  fact  which  cannot  be 
stated  too  emphatically.  The  city  mains  extend  well  over  that 
part  of  the  city  south  of  the  river  and  west  of  Shunganunga 

20 


creek.  Map  opposite  page  45  shows  parts  of  the  city  now 
served.  Some  4.738  service  connections  were  in  nse  in  1907.  a 
figure  which,  according  to  water  office  estimates,  accounted 
for  about  24.000  persons — or  some  55  per  cent  of  the  popula- 
tion. Realizing  the  great  importance  of  pure  water  in  the  pre- 
vention of  a  number  of  important  infectious  diseases,  we  may 
recommend  Hberal  extension  of  the  city  mains.  This  phase  of 
the  question  will  be  discussed  further  in  connection  with  that 
of  wells  and  privies:  for  the  present  it  is  sufficient  to  note 
that  the  quality  of  the  city  water  justifies  the  policy  of  its 
liberal  extension. 

SEWERAGE  AXD  SEWAGE  DISPOSAL 

The  sewerage  of  Toi3eka  consists  of  eight  systems;  one  in 
Xorth  Topeka.  the  other  seven  south  of  the  river  and  west  of 
Shunganunga  creek.  A  few  short  storm-water  drains  have 
been  laid  on  the  east  side,  but  sanitary  sewers  (for  house  sew- 
age) are  entirely  lacking  in  tliat  part  of  the  city.  Each  of  the 
eight  systems  has  its  own  outfall  into  the  river,  as  is  shown  in 
Figure  9,  and  all  are  "combined"  sewers,  i.  e.,  designed  to  carry 
both  house  sewage  and  storm-water.  The  location  and  rela- 
tiA^e  size  of  these  systems  is  indicated  below : 

Topeka  Sewer  Systems.  1913. 


Order  in 

ascending 

river 

Outfall  at 

Size  at  out- 

Tributary 

Population 

fall,  inches 

area,  acres 

served 

1 

Fairchild  St. 

34x54 

261 

4,000 

2 

Jefferson  St. 

54x58 

1067 

12,000 

3 

Xear  Madison  St. 

24  round 

28 

450 

4 

Xear  Monroe  St. 

24  round 

36 

550 

5 

ISTear  Quincv  St. 

15  round 

52 

900 

6 

City  Park. 

60x72 

645 

8.800 

7 

Qviinton  Blvd. 

27  round 

95 

750 

8 

Hawthorne  St. 

15  round 

483 

3,600 

It  is  evident  that  two  of  the  systems — Jefferson  street  and 
City  Park — are  relatively  large:  two — Xorth  Topeka  and  Pot- 
win — are  of  medium  size:  while  the  remaining  four  are  of 
relative  insignificance. 

A  comprehensive  and  valuable  survey  of  these  sewers  was 
made  possible  by  the  co-operation  of  the  State  Board  of  Health 
as  represented  by  Dr.  S.  J.  Crumbine.  and  the  University  as 


21 


represented  by  Professor  G.  R.  Jones,  who  is  also  Engineer  of 
the  State  Board.  The  work  was  carried  on  under  the  personal 
direction  of  Professor  Jones  by  Messrs.  E.  C.  Richardson,  H. 
D.  King-  and  W.  A.  Davenport,  senior  students  at  the  Univer- 


Topeka 

Improvement 

Survey 

1913 


/    L : 


FIG.  9.     TOPEKA  SEWER  SYSTEMS,  1913. 

Heavy  lines  outline  sewer  districts. 

Dot  and  dash  line  city  limits. 

Fine  lines  indicate  sewers;    the  circles  manholes. 

sity,  the  inspection  counting  as  thesis  work  towards  their  de- 
grees in  sanitary  engineering. 

The  plan  throughout  was  to  do  whatever  work  undertaken 
as  thoroughly  as  possible,  rather  than  to  try  to  cover  the  eu- 


22 


■Xlh 


i'i!'«''y\! 


:Ml 


It!;! 


tire  territoiy  in  a  superficial  manner.  All  of  the  large  sewers 
were  entered  and  explored,  a  large  number  of  man-holes,  flush 
tanks,  and  the  like  were  inspected,  and  a  number  of  places  spe- 
cially complained  of  were  thoroughly  investigated.  The  prin- 
cipal points  covered  Avere  the  dimensions,  type  of  material  and 
construction,  and  the  general  condition  of  the  various  parts  of 
the  systems.  Leakage  of  ground  water,  unevenness  of  grades, 
formation  of  deposits,  the  condition  of  joints  and  examples  of 
improper  design  were  also  noted.  The  total  mileage  of  Topeka 
sewers  is  approximately  73 ;  of  these  23  miles  were  inspected ; 
as  Avell  as  306  manholes  and  flush  tanks  out  of  a  total  of  950. 
Many  objectionable  conditions  were  found;  as,  for  in- 
stance, in  the  big  City  Park  sewer  where,  a  short  distance  from 
the  outfall,  the  bottom  is  badly  worn  and  an  inch  and  a  half 
crack  extends  in  the  top  for  about  200  feet.  In  addition,  the 
properly-constructed  house  connections,  originally  built  into 
the  sewer  at  each  25  feet,  have,  in  the  majority  of  instances, 
been  disregarded.  The  sewer  has  been  broken  into  in  the  most 
convenient  manner,  little  attention  being  given  to  making  the 
connection  tight  or  to  protecting  the  brick  work.  Similarly, 
out  of  six  flush  tanks  inspected,  three  were  found  in  good  con- 
dition, another  was  found  standing  full  with  no  flow  in  or  out, 
while  the  water  Avas  floAving  from  the  other  two  in  a  steady 
stream — all  flushing  action  being  thereby  lost.  The  detailed 
field  notes  of  the  inspection  may  be  found  in  Appendix  "D"; 
the  folloAving  discussion  being  quoted  directly  from  Professor 
Jones'  report : 

Discussion  of  the  Topeka  Seaver  Systems 
By  Prof.  Granville  R.  Jones 

Combined  Versus  Separate  ScAvers. 

"The  first  criticism  that  should  be  made  against  the  To- 
peka scAvers  is  that  they  carry  both  seAA^age  and  storm  water. 
The  chief  argument  in  favor  of  'combined'  sewers  is  their  Ioav 
first  cost.  As  a  rule,  this  is  much  loAver  than  for  separate 
sewers,  but  it  is  A^erj^  doubtful  whether  it  should  be  given  much 
consideration  in  the  building  of  a  public  utility  of  such  vital 
iniDortance  to  the  conA^enience  and  Avelfare  of  the  community. 
At  jDresent  fcAver  combined  systems  and  more  separate  systems 
are  being  built,  and  in  some  states,  of  AAdiich  Kansas  is  one,  the 

23 


combined  systems  are  prohibited  by  law  or  by  regulations  of 
the  State  Board  of  Health. 

"The  arguments  against  combined  sewers  as  applied  to 
Topeka  conditions  are  many.  For  example,  they  were  built  to 
carry  surface  drainage  as  well  as  house  sewage.  The  amount 
of  surface  drainage  during  heavy  storms,  therefore,  has  con- 
trolled their  design;  as  a  consequence,  during  dry  Aveather. 
when  only  house  sewage  is  flowing,  the  de^^th  of  the  flow  is 
in  many  places  far  less  than  the  allowable  minimum.  In  some 
places  there  is  barely  a  trickle ;  in  others  no  flow  at  all.  These 
low  velocities  and  shallow  dei3ths  have  resulted  in  heavy  de- 
posits of  sand,  mud,  and  house  sewage  sludge.  The  result  is 
foul  and  ill-smelling  sewers,  which  are  an  inexcusable  nuis- 
ance.^ 

Ventilation. 

"The  ventilation  of  the  Topeka  sewers  is  bad.  This  is  in 
part  a  penalty  exacted  by  the  combined  system,  as  the  change 
of  air  can  be  accomplished  much  more  rapidly  in  small  than 
in  large  sewers.  The  fault,  however,  does  not  lie  entirely  with 
the  system.  In  Topeka,  manholes  are  largel}^  used  for  ventila- 
tion, ve-ry  few  manholes  with  tight  covers  being  found.  It 
would  be  much  more  convenient,  and  much  more  pleasant  for 
the  community  immediately  adjacent  to  the  ill-smelling  sewer 
line,  to  close  the  manholes  tight  and  have  the  sewer  air  dis- 
charged through  house  stacks  above  the  roofs.  This  is  the 
more  modern  and  approved  method  of  sewer  ventilation. 

Design. 

"It  is  not  practicable  with  the  data  at  hand  to  go  very 
deeply  into  the  question  of  the  adequacy  of  the  existing  To- 
peka sewers.  It  may  be  said,  however,  that  with  some  excep- 
tions, the  sewers  are  of  sufficient  size.  The  one  ver}^  great  ex- 
ception is  in  the  Potwin  sewer.  At  the  corner  of  Sixth  and 
Morris  avenues,  two  30-inch  brick  sewers  join  and  discharge 
into  one  15-inch  pipe.     The  grades  of  these  sewers  were  not 

lAs  examples  of  such  conditions  see  paragraphs  in  the  field  notes 
(Appendix  "D")  referring  to  some  of  the  places  where  either  de- 
posits or  bad  odors  were  found,  as  follows:  City  Park  district — 
paragraphs  14,  16,  33,  34,  35,  36,  37,  39,  41,  42,  43,  45,  47  and  69; 
North  Topeka  district — paragraphs  1,  3,  5,  7,  8,  10,  11  and  12.  Places 
especially  complained  of — paragraphs  2,  4,  5,  9,  17,  19,  20;  Jeffer- 
son street  district — paragraphs  2,  4,  7,  8,  9,  11,  12,  15,  16,  17,  18, 
23,  24,  26,  27,  28,  30,  31,  34,  38,  39,  41,  42,  43,  44,  46,  47,  49,  50, 
51,  52,  54;    all  paragraphs  under  flush-tanks, 

24 


available  from  the  office  records  and  were  not  determined,  but 
the  discharge  of  two  30-inch  sewers  flowing  full  wdth  a  ve- 
locity of  flow  equal  to  the  minimmn.  could  not  possibly  be 
carried  by  one  15-inch  sewer  laid  on  a  reasonable  grade,  or 
with  an  allowable  velocity.  The  arrangement  found  here  was 
constructed  before  the  present  Kansas  XVater  and  Sewage  law 
was  jDassed.  or  would  never  have  been  allowed :  it  represents 
a  foolish  and  shameful  waste  of  funds.  The  results  justify 
the  characterization  of  this  work  even  as  criminal.  Sewage 
stands  in  the  manholes  in  this  neighborhood  far  above  the 
crown  of  the  sewers:  foul  odors  are  present  continually:  and 
with  every  rain,  even  with  moderate  rains,  sewage  overflows 
into  the  streets.     These  conditions  are  disgraceful. 

"An  opx^ortunity  to  remedy  this  condition  is  now  presented. 
A  new  sewer  district  immediately  to  the  west  of  that  above 
mentioned  is  now  being  advocated,  and  the  plans  which  have 
been  drawn  call  for  an  outfall  line  to  follow  closely  the  much 
overloaded  15-inch  line.  The  project  has  even  progressed  so 
far  that  the  City  Commissioners  have  allowed  the  petition  for 
its  construction:  but  the  matter  has  not  yet  come  before  the 
State  Board  of  Health,  and  there  is  a  probal)ility  that  some 
relief  on  the  Pot  win  situation  will  be  required  before  a^Dproval 
of  the  new  work  is  given.  Certainly  the  city  should  at  this 
time  take  advantage  of  its  opportunity  and  either  replace  the 
present  15-inch  line  with  one  capable  of  carrying  all  the  sew- 
age from  the  combined  district,  or  construct  a  relief  sewer  be- 
side the  present  one. 

"Another  matter  requiring  attention  relates  to  the  grades 
or  slopes  of  the  sewers.  In  several  places  the  grades  are  so 
low  that  the  velocities  are  much  less  than  is  allowable.  In 
other  places,  the  depth  of  flow  is  much  Ijelow  the  minimum, 
due  to  grades  which  are  too  flat.  These  places  are  referred  to 
in  the  discussion  of  Combined  vs.  Separate  Sewers  (page  23). 

"Inlet  manholes  are  quite  generally  used  in  Topeka.  such 
being  very  i30or  practice.  All  inlets  should  be  equipi^ed  with 
catch  basins,  which,  if  properly  designed  and  maintained, 
would  keep  out  a  great  deal  of  the  sand  and  mud  found  in  the 
sewers  during  the  inspection.  Most  of  the  catch  loasins  in  use 
are  very  well  designed;  some,  however,  are  not.  and  should  be 
reconstructed.  These  are  the  ones  into  which  it  is  difficult  to 
enter,  and  which  it  is  almost  impossible  to  clean. 

"Drop  manholes  are  a  thing  unknown  in  Topeka.  When 
two  sewers  join  at  different  levels,  the  practice  has  been  simply 
to  allow  the  upper  one  to  project  through  the  wall  of  the  man- 
hole. This  has  caused  wear  on  the  sides,  deposits  on  the 
benches,  churning  in  the  invert,  and  obstructed  flow.     Exam- 

25 


pies  of  poorly  designed  manholes,  iiilets,  catch-basins,  etc.,  may 
be  found  in  Appendix  "D,''  City  Park  District,  paragraphs  23, 
39  and  64;  Places  particularly  complained  of,  paragraph  2; 
and  Jefferson  Street  district,  paragraph  31. 

Records. 

"The  records  of  existing  construction  in  the  City  Engi- 
neer's Office  are  very  meager  and  unreliable.  Plans  for  all 
work  seem  to  exist,  but  there  is  no  assurance  that  they  corre- 
spond to  the  work  as  constructed.  In  practically  half  the 
cases  grades  are  not  available,  and  those  that  can  be  had,  are 
entirely  untrustworth3^  The  practical  value  of  complete  and 
reliable  records,  and  the  evil  results  of  their  absence,  is  illus- 
trated very  aptly  by  the  condition  found  in  the  City  Park  out- 
fall sewer.  In  "making  house  connections  to  this  sewer,  the 
properly  designed  and  placed  inlets  have  been  entirely  disre- 
garded,' the  wall  of  the  seAver,  as  has  been  mentioned  already, 
having  been  broken  through  and  the  house  drains  allowed  to 
project  into  the  sewer  without  any  attempt  to  make  the  con- 
nections tight.  The  lack  of  records  of  house  connection  inlets 
on  this  sewer  has  very  probably  been  the  cause  of  the  condition 
described. 

"In  the  matter  of  engineering  service  Topeka  has  been  sadly 
swindled  in  the  past,  as  the  records  of  the  office  and  the  work 
in  the  field  will  testify.  At  present,  affairs  are  conducted 
quite  differently,  and  ail  the  work  now  being  done  is  carefully 
recorded. 

Maintenance. 

"The  maintenance  of  To]3eka's  sex^ers  has  been  in  the  past, 
and  is  at  present,  extremely  poor.  It  might  be  said  that  there 
is  no  maintenance.  The  many,  many  places  where  the  sewers 
are  nearly  filled  with  deposits,  the  absence  of  even  one  clean 
catch  basin,  the  flush-tanks  out  of  order,  or  using  ten  times  the 
amoinit  of  water  necessary,  all  prove  this  statement.  The  de- 
partment having  charge  of  this  work  should  certainly,  at 
least  in  this  regard,  be  entirely  reorganized ;  or  preferably, 
the  work  should  be  placed  in  the  hands  of  the  City  Engineer 
and  an  efficient  corps  organized  to  carry  it  on.  The  sewers 
should  be  kept  clean.  Catch  basins  should  be  cleaned  after 
every  storm,  whereas  at  present  all  of  them,  or  most  of  them, 
are  so  filled  up  that  they  act  merely  as  inlets  of  poor  design. 
The  flush-tanks  should  be  cared  for  and  operated  economic- 
ally. 

Future  Extensions. 

"There  is  a  most  imperati^^'e  need  of  sewer  extensions  in  one 

26 


portion  of  the  city — the  section  east  of  Shunganunga  creek. 
Here,  within  the  limits  of  the  third  city  in  Kansas,  is  the 
largest  conimnnity  in  the  state  that  remains  nnsewered.  Its 
popnlation  is  in  the  neighborhood  of  7,000 — to  be  compared 
with  the  fact  that  there  are  in  the  state  bnt  two  towns  with  a 
l^opnlation  of  over  3,000  without  sewers,  and  with  this  excep- 
tion in  Topeka,  none  larger  than  5,000. 

•'It  is  stated  that  the  residents  of  this  district  do  not  want 
sewers.  Present  conditions  are.  nevertheless,  a  menace,  not 
only  to  residents  of  the  district,  but  to  other  citizens  of  Topeka 
as  well.  The  city  commissioners  are  empowered  to  frame,  pass 
and  enforce  snch  ordinances,  governing  the  construction  and 
maintenance  of  privies,  cesspools  and  other  'sanitary  make- 
shifts,' as  will  eliminate  all  danger.  These  regulations,  if  they 
are  as  they  should  be,  will  become  burdensome  enough  to  make 
sewers  a  necessity. 

Flood  Protection. 

"Topeka  has  recently  spent  many  Thousands  of  dollars  for 
flood  protection.  Some  discussion  has  arisen  as  to  whether 
the  works  constructed  are  adequate,  and  varying  opinions  have 
been  expressed.  For  the  purposes  of  this  discussion  it  will  be 
assumed  that  the  desired  result  other  than  that  in  which  the 
sewer  outlets  are  a  factor,  has  been  accomplished  and  that  the 
works  will  perform  their  function.  As  long,  however,  as  tho 
existing  outlets  pass  through  the  dike  without  means  for  clos- 
ing them  during  floods,  and  without  means  of  disposing  of  the 
city's  sewage  when  they  are  closed,  they  annul,  in  a  very  large 
measure,  the  advantage  of  flood  protection  and  the  money 
spent  for  the  work  is  wasted.  Xothing  whatever  will,  under 
the  present  conditions,  prevent  the  river  from  rising  through 
the  sewers  and  flooding  the  lower  district  of  the  city  to  the 
same  heights  as  formerly.  Every  outfall  should  be  equipped 
with  a  flap-valve  or  other  means  of  preventing  back  flow  from 
the  river  at  high  stages,  and  also  with  means  for  lifting  the 
sewage  over  the  dike  and  into  the  risen  stream.  The  sewage 
might  be  more  economically  collected  at  one  place  and  pumped 
entirely  through  one  station,  or  it  might  possibly  be  carried 
down  the  river  by  a  long  outfall  sewer  and  discharged  without 
pumping.  These,  however,  are  details  which  would  be  worked 
out  in  designing  of  the  project.  That  some  decided  improve- 
ments along  this  line  are  imperative  is  very  evident. 

'Tt  may  sometime  become  necessary  for  Topelca  to  purify 
its  sewage  before  discharging  it  into  the  river.  The  disadvan- 
tage of  a  combined  system  will  then  become  even  more  evident. 
Treatment  works  for  combined  sewage  are  necessarily  much 
larger  and  more  expensive  than  for  house  sewage  alone. 

27 


Summary  and  Hecommendations. 

"As  a  whole,  Topeka  has  a  poorly  designed,  a  poorly  con- 
structed, and  a  i^oorly  maintained  sewer  system.  Many  of  the 
things  that  haA^e  been  done  can  not  be  changed,  but  there  are 
a  large  number  of  betterments  that  should  be  undertaken  at 
once.  These  will  be  enumerated,  but  not  in  the  exact  order  of 
their  importance,  because  some  are  equally  necessary;  but  the 
first  ones  should  be  started  at  once. 

1.  A  complete  survey  of  the  sewers — to  supply  missing 
records,  and  verif}^  the  available  records  of  the  City  Engi- 
neer's Office.  This  probably  can  not  be  done  by  any  force  in 
the  present  city  department ;  but  a  special  corps  of  men  should 
be  employed  at  once. 

2.  All  the  sewers  and  appurtenances  should  be  thorough- 
ly cleaned.  They  should  be  kept  in  this  condition  b}^  a  prop- 
erly organized  department  of  maintenance. 

3.  All  needed  repairs  ^  to  manholes,  flush  tanks,  sewer 
inverts,  etc.,  should  be  attended  to  at  once. 

4.  The  relief  of  the  Potwin  sewer  district  should  not 
longer  be  neglected. 

5.  A  sewer  system  for  East  Topeka  should  be  started 
without  "unnecessarj^  delay. 

6.  All  outfalls  should  be  equipped  with  the  means  for 
their  closing  during  flood  periods  of  the  Kansas  river,  and 
should  be  equipped  with  pumping  stations.  Or  the  alterna- 
tive plan  of  collecting  all  of  the  sewage  at  one  point  and  in- 
stalling one  pumping  station  should  b?  adopted." 

MILK    SUPPLY. 

Topeka 's  milk  supply  is  produced  entirely  by  farmers  liv- 
ing within  a  radius  of  a  few  miles,  or  at  least  within  such  dis- 
tance that  the  milk  is  brought  in  by  wagons.  Some  milk  enters 
the  city  by  railroad  from  Meriden  and  Nortonville,  but  ac- 
cording to  the  statement  of  the  purchasing  company,  it  is  all 
skimmed  and  used  for  the  manufacture  of  butter.  Production 
rests,  according  to  figures  furnished  by  the  cit}?'  milk  inspector, 
in  the  hands  of  some  177  farmers,  who  may  be  conveniently 
classified  with  reference  to  the  manner  in  which  they  dispose 
of  their  milk — whether  wholesale  or  retail — in  bulk  or  in  bot- 
tles.   The  detailed  information  is  as  on  the  following  page. 

1  Places  needing  repairs  are  described  in  Appendix  "D"  as  follows : 
City  Park  District,  paragraphs  1,  2,  4,  28,  53  and  59;  places  particularly 
complained  of,  paragraphs  6.  7,  24,  27,  41,  42  and  55. 

28 


Milk  Productiox.  Topeka.  1913.^ 
(Figures  furnished  by  City  Milk  Inspector  ) 


-.-,<;      Average  dailv 
-n     1  m-  X-      T,  ZSumber  of  ■  j.       ' 

Producers  selling —  ^ umber    ,  ^^^__  i  quarts 

prod  Liced 


Wholesale    and    retail    in 

bottles 

Wholesale  in  bottles 

Wholesale  in  bulk 


25 

342 

2.173 

17 

218 

1.615 

135    j 

962* 

5,310 

Totals 177         i         1,522  9,098 


"Xumber  of  cows  not  stated  for  31  producers. 

Most  of  the  milk  ( oS.-i  per  cent )  is  sold  in  bulk  to  middle- 
men, something  less  than  a  fonrth  being  sold  directly  by  the 
producer  to  the  consumer.  The  actual  retailing  is  carriei]  out 
about  as  follows,  the  amount  handled  Ijy  depots  and  compa- 
nies being  greater  than  would  appear.  a>  they  furni-h  a  good 
proportion  of  the  store  milk : 

Eetailixg  of  Milk.  Topeka.  1913. 
(Figures  furnished  by  City  Milk  Inspector  ) 

By  producers 2,371   quarts  per    day 

By  depots  and  companies 3,406   quarts  per    day 

Bv  stores 2,055    quarts  per   day 


Total 7,832    quarts   per   day 

AVhile  a  marked  discrepancy.  l.i^6G  quarts  per  day.  exists 
in  the  milk  inspector's  estimates  of  production  and  sales,  the 
figures  give,  no  doubt,  a  fair  approximation  of  the  situation. 
They  are  sufficient  to  indicate  that  Topeka 's  milk  problem 
centers  in  the  inspection  of  some  177  dairy  farms,  some  seven 
depots  (which  handle  about  two-thirds  of  the  supply),  and  a 
large  number  of  grocery  stores.  The  railroad  shipment  prob- 
lem is  absent:  and.  with  a  proper  inspection  service,  there  is 
no  reason  why  Topeka  should  not  have  its  milk  supply  in  ex- 
cellent condition. 

Existing  City  Milk  Ixspectiox. 

To  protect  the  supply  the  city  has  pas>ed  a  milk  ordinance 
(1910)  and  provided  a  milk  inspector.    The  requirements  are, 
in  brief,  to  the  effect  that  all  dairymen  must  be  registered 
1  For  further  details  see  Appendix  "E". 

29 


with  the  city  milk  inspector  and  pay  a  license  fee  varying  with 
the  size  of  their  business;  they  are  forbidden  to  produce  milk 
in  unsanitary  places  or  from  unclean  cows;  the  milk  shall  be, 
one  hour  after  drawn  and  at  all  times  thereafter,  at  tempera- 
tures below  60  degrees  Fahrenheit ;  all  milk  must  be  retailed 
in  closed  containers — thus  practically  requiring  bottles;  and 
all  cows  must  be  healthy  and  shall  have  passed  the  tuberculin 
test.  Chemical  standards  are  also  set  up,  preservatives  are  for- 
bidden, and  it  is  specified  that  the  city  milk  inspector  shall 
score  dairies  and  take  and  analyze  samples  of  milk. 

The  p]:ovisions  of  this  ordinance,  which  was  passed  in  Oc- 
tober, 1010,  have  not  b-^f^n  ob'=ervpd  in  nny  adequate  way.    Keg- 


A   TOPEKA   DAIRY. 

Within    tlie    city   limits,   but   unregistered   and    unknown    to    tlie    mill-:    in- 
spector.    Cows  kept  in  smtill  coal   shed    (door  open)  ; 
milk  sold  to  nearby  store. 

istration  of  producers  and  dealers  has  not  been  carried  out,  nor 
has  the  requirement  of  tuberculin  testing  of  cows  been  en- 
forced. No  dairy  score  cards  are  on  file  as  is  required  b}-  or- 
dinance, the  inspector  stating  that  he  has  made  inspections,  but- 
has  thrown  the  cards  away;  nor  have  the  required  annual  re- 
ports been  filed. 

The  actual  milk  tests  employed  are,  furthermore,  not  such 
as  to  adequately  determine  the  sanitary  character  of  the  city's 
milk,  having  been  limited  to  fat  determinations  to  detect 
watering,  and  simple  straining  through  cotton  filters  to  detect 
visible  dirt.     Such  tests  are  quite  inadequate  from  a  sanitary 

30 


ANOTHER  TOPEKA  DAIRY. 

Tliirty-two  cows  kept  iii  this  barn,  which  is  of  wretched  construction,  al- 
lowing practically  no  light   or   ventilation.     Milk  from  this 
dairy  goes  to  some  of  the  best  parts  of  the  city. 

standpoint.  Producers  qnicklY  realize  that  it  is  necessary 
merelv  to  use  cotton  filters  themselves,  whereupon  their  milk. 
Tvhicli  orio'inally  nuiv  liave  liet^n  ^"erv  dirty,  is  quite  >afe  from 
detection.  The  best  indication  of  the  sanitary  character  of 
milk  can  be  obtained  only  by  utilizino-  the  bacteriological  ex- 
amination, an  operation  callino-  for  some  laboratory  equipment 


BARNYARD   OF  DAIRY  ABOVE. 
Cows  and  barn  in  tilthv  condition. 


31 


and  some  skill  on  the  part  of  the  inspector.  It  is  the  test  em- 
ployed, however,  by  all  up-to-date  milk  inspection  systems,  and 
its  use  in  Topeka  is  strongly  advocated. 

The  Survey  Milk  Inspections. 

A  survey  of  the  Topeka  milk  situation,  including  an  in- 
spection of  a  fair  number  of  dairy  farms  and  the  examination 
of  a  considerable  number  of  samples  of  milk,  was  made  pos- 
sible through  the  co-operation  of  the  State  Dairy  Commis-. 
sioner,  George  S.  Hine,  and  the  State  Board  of  Health,  as  rep- 
resented by  Dr.  Crumbine.  Eighteen  farms,  selected  to  rep- 
resent good  and  bad  conditions,  were  visited  in  company  with 
Dr.  Babb,  citj^  milk  inspector,  and  were  scored  by  Mr.  Hine. 
In  interpreting  the  following  results  it  should  be  borne  in  mind 
that  a  perfect  score  for  equipment  is  40,  and  for  methods  60  — • 
making  a  possible  perfect  total  of  100. 

Dairy  Scores,  Topeka  Improvement  Survey,  December,  1913. 

(Scores  bv  G.  S.  Hine,  State  Dairy  Commissioner) 


Prodycer 

Xo.  cows 

Score  for 
equipment 

Score  for 
methods 

Total  score 

"A" 
"B" 
"C" 
"D" 
«E" 
"F" 
"G" 
"H" 
ii-t>' 

"J" 
"K" 
"L" 

"M" 
"N" 
"0" 
"P" 
"Q" 
"R" 

23 

27 

25 

42 

42 

10 

16 

9 

7 

32 

23 

4 

6 

2 

5 

20 

4 

14 

27.00 

31.00 

31.25 

25.75 

22.75 

19.00 

17.25 

16.50 

17.75 

10.75 

14.00 

9.50 

9.25 

11.50 

6.50 

6.50 

9.25 

8.50 

54.00 
45.00 
42.50 
45.50 
48.00 
41.75 
37.50 
37.75 
36.00 
.34.00 
24.00 
26.00 
25.50 
21.75 
24.00 
23.50 
19.00 
18.00 

81.00 
76.00 
73.75 
71.25 
70.75 
60.75 
54.75 
54.25 
53.75 
44.75 
38.00 
35.50 
34.75 
33.25 
30.50 
30.00 
28.25 
26.50 

Totals .  . . 
Average. . 

311 

17 

294.00 
16.32 

603.75 
33.54 

897.75 
49.88 

Even  allowing  for  the  fact  that  the  United  States  Depart- 
ment of  Agriculture  score  card  (used  in  these  inspections  and 
required  by  the  Topeka  ordinance)  is  rather  hard  on  the  small 
producer,  these  scores  are  hardly  flattering  to  the  city.     The 


32 


rSXIDEXTALLY  A  MILK  DEPOT 
The  occupant  of  this  house  kept  five  cows  hiuiseli  and  bought  milk  from 
ten  other  dairymen.     Bottling  and  all  other  milk-handling  opera- 
tions carried  out  on  back  porch.    Surroundings.,  equipment 
and  methods  objectionable. 

showing  for  niPthocls  is  somewhat  Ijetter  than  that  for  equip- 
ment :  but  it  i^  unnecessary  to  point  out  that  very  poor  places 
were  found,  such  as  the  Topeka  ordinance  —  and  decency,  for- 
bids. 

Samples  of  milk  were  taken  from  stores  and  delivery 
wagons  by  state  food  inspectors,  and  were  subjected  to  chem- 
ical ami  l)acteriological  analysis.  Mo^t  of  the  bacteriological 
samples  were  analyzed  in  Topeka  by  Prof.  L.  I).  Bushnell  of 
the  State  AgTicultural  College,  although  sonu-  avpiv  taken  in 
sterile  tultes.  properly  iced,  and  sent  to  him  at  ^Manhattan. 
The  chemical  r^amples.  -2'  in  number,  were  all  analyzed  at  the 
Agricultural  College,  and.  with  the  exception  of  one  sample 
that  indicated  added  water,  jjroved  satisfactory.-  The  bacterio- 
logical rer-nlt~  are  indicated  on  the  next  page. 

The-e  figure:-  rcpre-ent  a  shockino-  -ituation — lo  per  cent 
of  the  sample-  containing  over  1m.iioii.(!iii)  bacteria  to  the  cubic 
centimeter,  with  nearly  half  o\"er  I.mho.oiKi  ;  •nul  thi~  in  the  cool 
1  For  details  see  Appendix  "E". 


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34 


DAIRY   SCORING   2614    PER   CENT. 
Unregistered  and  uninspected. 

months  of  Xovember  and  December.  In  Boston  nearly  two- 
thirds  of  all  these  samples  would  have  been  illegal,  and  Bos- 
ton's maximum  —  500.000  per  cubic  centimeter  —  is  liberal  as 
compared  with  other  existing  municipal  standards,  such  as 
300,000  and  100,000.  The  plain  indication  is  that  Topeka  is 
getting  dirt}^  milk — some  remarkably  dirty  milk;  the  visible 
dirt  may  be  removed,  but  the  milk  has  evidently  been  very 
carelessly  handled,  or  is  very  old,  or  both. 

Middlemen's  milk,  i.  e.,  milk  purchased  in  bulk  and  bottled 
at  depots  and  creameries,  made  a  poorer  showing  than  that  sold 


WITHIN  THE  CITY  LIMITS. 

Unregistered   and   uninspected   dairy.     Also   typical   of   tlie   "family    cow" 

problem.     Some  300  of  such  cows  being  kept  in  the  city.    Incidentally 

this  picture  represents   a    survival  of  rural   conditions   in  the 

city — as  witness  the  cows,  hens,  well  and  privy. 

35 


.-sa^^. 


A    CLEAN   MILK   HOUSE. 
A  proper  place  for  straining  and  bottling. 

direct  by  the  producers.    Comparison  of  the  figures  beloAv  with 
those  on  page  31  brings  out  this  point. 

Here  we  Iiave  an  average  of  11,200,000  to  compare  with 
one  of  6,352.000  for  all  samples  taken.  The  proportion  is 
the  more  remarkable  in  that  IT  out  of  the  20  samples  of  mid- 

Bacteriological  CorxTS  of  Middlemen's  Milk,  Topeka  Im- 

PROYEMEXT   SuRATA'.   XoVEMBER   AXD   DECEMBER,   1913. 


Individual  or 
firm 

Number  of  Samples 

Average  count 

Remarks 

«rp5> 

"U" 
"V" 
"W" 
"X" 

12 
5 

4 
3 
1 
1 

1,130,000 
18,500,000 
34,100,000 

6,770,000 
18,000,000 
11,000,000 

pasteurized 
pasteurized 

Totals 

26 

11,200,000 

dlemen's  milk  had  been  pasteurized.  Restricting  the  compari- 
son to  strictly  store  samples  the  average  figures  are  5,250,000 
for  farmers'  samples  as  against  11.900,000  for  those  from  mid- 
dlemen. An  inspection  of  the  three  largest  depots  in  town 
discovered  one  in  a  cleanly  condition,  one  fairly  so,  and  one 
to  be  very  dirty. 

Altogether,  these  low  scores  and  high  counts  indicate  that 
Topeka  has  a  very  real  milk  problem ;    and  that  a  joroper  be- 


36 


ginning  towards  its  solution  remains  to  be  made.  Under  the 
existing  inspection  many  of  the  producers  (and  some  actually 
within  the  city  limits)  are  unregistered  and  unknown  to  the 
inspector.  Others  probably  receive  a  superficial  examination, 
although  there  is  no  record  on  file  to  show  that  they  receive 
any.  In  fact,  if  the  only  available  records,  those  printed  from 
month  to  month  in  the  newspapers,  are  to  be  taken  as  an  in- 
dex, the  inspection  has  consisted  chiefly  in  taking  samples 
from  peddlers  for  fat  and  visible  dirt  determinations.  It  is 
only  fair  to  say,  however,  that  the  salary  paid  the  milk  in- 
spector, $100  a  month,  is  inaclequat?  compensation  for  a 
trained  and  experienced  man,  and  that  the  inspector  has  been 
made   to   furnish   his   own   equipage.      The   idea    of   monthlv 


A  SLOVENLY  MILK  HOUSE. 
Contrast  this  with  the  one  opposite. 


newspaper  publicity  of  inspection  results  is  also  good,  and  its 
continuance  is  urged.  Such  considerations  cannot,  however, 
blind  us  to  the  fundamental  inadequacy  of  the  inspection 
system. 

In  considering  improvements,  certain  changes  in  the  milk 
ordinance  are  to  be  advocated ;  as  for  example,  the  removal 
of  the  clause  specifying  that  the  inspector  shall  be  a  veteri- 
narian, a  provision  which  is  no  guarantee  whatever  of  famili- 

37 


arity  with  modern  methods  of  milk  inspection,  and  which  is 
very  likely  to  be  an  embarrassment  in  securing  a  suitable  man. 
This  provision  is  especially  worthless  if,  as  has  been  the  case, 
it  is  not  intended  to  enforce  the  requirement  of  tuberculin 
testing.  For  the  rest  it  is  sufficient  to  point  out  the  necessity 
for  more  complete  registration  of  producers  and  dealers;  for 
the  systematic  inspection  and  scoring  of  dairy  farms;  for  the 
institution  of  bacteriological  examination,  with  the  provision 
of  more  laboratory  facilities ;  for  the  continuance  of  the  pres- 
ent publicity  idea ;  and  for  the  encouragement  of  proper  pas- 
teurization. The  fault  with  present  conditions  is  not  so  much 
with  the  plan  as  laid  down  in  the  milk  ordinance;  but  con- 
sists rather  in  lack  of  its  application.  The  inspector^  should 
be  a  properly  trained  and  experienced  man,  and  should  be 
more  liberally  treated  as  regards  salary,  equipage,  and  assist- 
ance. With  such  a  man  installed,  and  with  a  campaign  of 
education  under  way,  Topeka  should  be  able  to  make  great 
strides  in  the  improvement  of  its  milk  supply. 

Ice  Cream. 

The  quality  and  inspection  of  the  city's  ice  cream  are,  of 
course,  matters  closely  related  to  its  milk  problem.  Dirty  or 
stale  cream  is  just  as  objectionable  as  dirty  or  stale  milk,  and 
the  causes  and  prevention  of  both  conditions  are  much  the 
same.  Manufacture  of  ice  cream  in  Topeka  is  largely  in  the 
hands  of  three  concerns,  tAvo  of  which  are  also  large  milk 
depots.  Inspection  of  these  places,  and  of  a  smaller  manu- 
factory, by  Prof.  E.  M.  Twiss  and  students  from  Washburn 
College,  showed  that  both  equipment  and  methods  left  much 
to  be  desired.  One  of  the  large  places  was  found  in  a  satis- 
factory condition,  in  another  the  equipment  was  poor  and 
the  methods  only  fair,  while  in  the  third  both  equipmnet  and 
methods  were  extremely  crude.  These  conditions  are  reflected 
in  the  results  of  the  bacteriological  examinations,  which  are 
listed  in  the  table  opposite. 

The  samples  in  question  were  all  taken  from  drug  stores, 
candy  stores,  hotels  and  restaurants;  and  were  taken  directl}' 
to  the  college  laboratories  and  examined.     The  aim  was  to 

iThe  city  milk  inspector  in  office  during  the  Survey  resigned 
during  the  preparation  of  this  report. 

38 


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40 


secure  samples  of  ice  cream  just  as  it  was  being-  eaten  by  con- 
sumers. Xo  comment  is  needed  to  emphasize  the  fact  that  the 
counts  are  rehitively  gigantic,  especially  as  presumably  sweet 
cream  is  used  in  every  case.  In  the  nature  of  things  cream 
always  has  a  higher  bacteria  count  than  milk:  but  the  normal 
differences  are  nothing  like  those  exhibited  above :  nor  is  the 
content  of  fresh,  carefully-handled  cream  anywhere  near  as 
gTeat. 

The  remedy  for  the  situation  is  the  same  as  that  for  the 
milk  prol^lem :  inspection  and  analysis  by  the  city,  with  pub- 
licity for  the  results.  Such  a  program,  properly  carried  out. 
will  quickly  produce  results  of  a  surprising  character.     Pro- 


IN    ONE    OF    TOPEKA'S    GOOD    DAIRIES. 

Contrast  these  conditions  with  those  shown  on  page  31. 

The    dairy    has   been  built    np   with   very   little 

capital  and  is  a  financial  success. 

ducers  and  handlers  readily  become  more  careful  and  cleanly 
when  they  realize  that  the  public  wants  these  things.  Here, 
evidently,  is  more  work  for  the  milk  inspector. 

FOOD    SUPPLY. 

The  city's  food  supply,  from  a  sanitary  standpoint,  in- 
volves the  inspection  of  the  various  foods  consumed  and  the 
places  in  which  it  is  handled  and  sold.  The  problem  is  to  see 
that  the  food  is  intrinsically  sound  and  that  it  is  handled  in 
a  sanitary  way.  The  chief  points  which  call  for  attention  are 
the  inspection  of  meats  and  groceries,  and  of  markets,  baker- 
ies,  restaurants,    commission   houses,   and   the   like.      Certain 


41 


well-recognized  potential  clangers  to  health  exist  in  the  food 
supply,  to  meet  which  definite  municipal  inspection  systems 
have  been  devised.  In  Topeka,  as  in  most  cities,  food  inspec- 
tion is  under  the  city  health  department. 

A  brief  survey  of  the  local  food  situation  shows  that  the 
city  annually  consumes  well  over  a  million  pounds  of  meat; 
and  that  this,  and  other  food  commodities,  is  disposed  of  in 
some  160  groceries  and  markets.  There  are  besides  some  five 
commission  houses  and  about  24  restaurants.  The  particulars 
as  to  the  source  and  amount  of  Topeka's  meat  supply  are  given 
in  the  table  on  page  41,  based  on  the  city  food  inspector's 
monthly  reports. 

The  very  large  part  of  the  city's  meat  is  evidently  slaugh- 
tered at  Kansas  City  and  other  points,  and  shipped  into  the 
city  dressed.  This  meat  is  all  inspected  by  the  federal  gov- 
ernment. Ninety-five  per  cent  of  the  local  meat  is  slaugh- 
tered by  the  Wolff  Packing  Company  and  also  receives  gov- 
ernment inspection. 


The  Survej^  Inspection. 

A  very  careful  and  complete  inspection  of  groceries  and 
markets  was  made  during  the  Survey,  again  through  the  gen- 
erous co-operation  of  the  State  Board  of  Health.  Five  state 
food  and  drug  inspectors  were  called  in  from  out  over  the 
state;  and  went  over  the  situation  in  very  considerable  de- 
tail. Regular  state  score  cards  were  used,  the  inspectors  be- 
ing instructed  to  give  special  attention  to  toilets  and  washing 
facilities.  Altogether  some  219  places  were  visited,  and  in- 
spections were  made  covering  2,905  separate  items.  Of  the 
latter  1,976  were  found  in  satisfactory  condition,  while  in  929 
instances  (32  per  cent  of  the  total)  orders  were  issued  for  im- 
provement. Ninety  items  (3  per  cent  of  the  total)  received 
the  lowest  mark  on  the  score  card.  The  detailed  findings  are 
shown  on  the  opposite  page. 

Examples  of  filthy  floors  and  walls  were  found,  as  were 
considerable  amounts  of  old  and  spoiled  goods.  The  find- 
ings most  serious  from  the  sanitary  standpoint  are,  however, 
the  great  prevalence  of  inadequate  toilet  facilities,  especially 

42 


Food  Inspection,  Topeka  Improvement  Survey,  Nov. 

(Inspection  made  by  State  Board  of  Health.) 


1913. 


Gro- 
ceries 
and 
markets 


Bake- 
ries 


Whole- 
sale 
fruit  and 
produce 


Confec- 
tionary 
stores 


Drug 
stores 


No.  of  places 

No.  of  employes .... 
Items  found  in — 

"Good"   condition.. 

"Fair"    condition.  . 

"Poor"   condition.. 

Refrigerators  found 
in — 

"Good"   condition. . 

"Fair"   condition.  . 

"Poor"  condition.  . 
Exposed  goods — 

None 

Some 

Bad 

Screening — 

Satisfactory 

Fair 

Poor 

Down 

Flies  present — 

"Many" 

"Some" 

Few 

None 

Privy  used 

C  o  n  n  e  e  ted  with 
sewer 

Vault.  .  . 

Not  stated 

Average  distance 
from  store 

Least   distance. . .  . 

Greatest  distance.. 
Water  closet  used..  . 

In  cellar 

Upstairs 

V  e  n  t  i  1  ates  into 
store 

In  residence 

In  hack  room 

In   barn 

Washing   facilities — 

"Good" 

"Fair" 

"Poor" 

"Bad" 

None 

Refrigerator  drip.. 

Residence 


147 
574 

1456 

586 

53 


23 
11 

50 

36 

4 

21 

5 

1 
25 

10 

9 
10 

4 

83 

20 
29 
34 

62  ft. 
10  ft. 
200  ft. 
39 
9 


6 
4 
3 
1 

17 

46 

42 

3 

11 

8 

7 


17 
106 


132 


22 


47  ft. 
30  ft. 
75  ft. 


5 

86 

31 
24 


6 
41 

24 

11 

2 


44 
136 

333 

141 

11 


1 
1 
6 

53  ft. 
30  ft. 
100  ft. 
18 
4 


11 
3 
1 


48 


when  taken  with  reference  to  lack  of  proper  provision  for 
washing  the  hands.  In  two-thirds  of  these  food-handling 
places  the  only  toilet  convenience  is  the  privy  and  in  less  than 
one-seventh  of  the  places  are  the  washing  facilities  such  as 
would  give  a  reasonable  guarantee  of  clean  hands.  The  prac- 
tice of  hurriedly  washing  the  hands  in  the  accumulated  re- 
frigerator drip  water,  and  wiping  them  on  the  ubiquitous 
apron,  cannot  but  be  condemned. 

While  the  lateness  of  the  3^ear  did  not  allow  a  fair  test  of 
screening  against  flies,  it  is  noteworthy  that  flies  were  found 
in  a  very  considerable  number  of  instances.  Here  again  the 
nearby  privy  assumes  an  ominous  portent,  the  inevitable  in- 
ference being  that  the  coml^ination  must  give  rise,  during  the 
summer  fly  season,  to  a  real  problem  in  food  sanitation.  The 
advisability  of  setting  up  and  enforcing  certain  standards  of 
toilet  and  washing  facilities  is  obvious,  and  surelj'  worthy  of 
serious  consideration. 


The  City's  Food  Inspection. 

For  the  supervision  of  these  various  food  problems  the 
city  provides  one  food  inspector.  A  mere  recital  of  his  theo- 
retical duties — including  the  inspection  of  all  meats  shipped 
into  the  cit}^,  the  supervision  of  all  local  slaughtering,  and  the 
inspection  of  all  markets,  groceries,  commission  houses,  huck- 
sters, and  eating  places,  quickly  shows  that  the  work  is  of 
impressive  amount  to  be  handled  by  one  man.  In  the  present 
instances,  however,  the  inspector  must  also  act  as  sealer  of 
weights  and  measures.  The  result  is  what  might  be  expected. 
The  inspector  does  not  give  any  systematic  attention  to  stores 
and  other  food  handling  places,  being  content  with  the  super- 
vision of  dressed  meat  as  it  enters  the  city. 

And  even  this  meat  inspection  is  to  a  large  extent  a  vain 
effort.  AYe  have  seen  from  the  table  on  ]3age  40  that  the  very 
large  pro])ortion  of  Topeka's  meat  is  shipped  in  by  rail,  and 
that  over  90  per  cent  of  the  local  meat  is  slaughtered  by  the 
"Wolff  Packing  Company.  Tlie  imported  meat  and  that  from 
Wolff's,  making  up  over  95  per  cent  of  the  city's  supply,  has 
all   undergone   government   inspection,   which   is  much   more 

44 


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rigid  and  tliorough  than  anything  practicable  for  the  city  to 
attempt.  It  is  ^vith  a  re-inspection  of  this  meat  that  the  city 
inspector  occupies  practically  his  entire  time. 

Meat  slaughtered  by  small  local  parties,  and  Avhich  has  no 
govermnent  inspection,  is  sometimes  seen  by  the  local  in- 
spector on  the  hoof,  and  presumably  always  after  dressing. 
The  inspector  cannot,  however,  be  present  at  the  time  of  kill- 
ing— the  most  important  as  far  as  detecting  diseased  meat  is 
concerned;  so  that  at  the  very  point  where  local  meat  inspec- 
tion would  be  considered  most  desirable,  the  service  is  inade- 
quate. 

A  ver}^  considerable  revenue  accrues  to  the  cit}^  on  account 
of  its  meat  inspection  activities,  in  the  year  taken  as  the  basis 
of  the  table  on  page  40,  $2,488.22.  At  the  same  time  no  meat 
was  found  which  merited  condemnation.  Three-fourths  of  this 
income  is  derived  from  the  outside  packers,  approximately  an- 
other fifth  from  the  AVolff  Packing  Company.  The  fees 
charged  at  present  are  15  cents  per  100  pounds  on  outside 
meat,  and  from  5  to  25  cents  a  head  on  various  animals  slaugh- 
tered locally.  It  would  seem  that  these  rates  discriminate 
against  outside  meat,  and  are,  furthermore,  an  unfair  burden 
on  packers  Avho  are  already  paying  for  government  inspection. 
In  addition,  the  city  obviously  makes  a  substantial  profit  on 
the  enterprise,  obtaining  some  $2,500  a  year  in  fees  as  against 
outlays  of  $900  for  the  inspector's  salary  and  an  additional 
$50  for  incidental  expenses.  Under  the  circumstances,  the 
small  salary  paid  the  inspector  (he  must  furnish  his  own 
equipage)  and  the  inadequate  food  protective  service  rendered 
are  particularly  inexcusable. 

Summary. 

To  sum  up  the  situation.  Topeka's  food  ins]:)ection  system 
is  entirely  inadequate  to  the  problem  in  hand,  and  may  be 
characterized  as  chiefly  a  money-making  proposition.  Atten- 
tion is  limited  to  the  inspection  of  meat,  an  operation  which  at 
present  consists  principally  in  distributing  tags  and  collecting 
the  fees  therefor  on  meat  which  has  already  had  rigorous  fed- 
eral inspection.  A  slight  possibility  exists  of  course  that  meat 
shipped  from  Kansas  City  might  spoil  in  transit ;  but  the  pos- 

45 


sibility  is  remote,  and  a  better  place  to  look  for  such  trouble 
would  be  at  the  market,  where  other  conditions  may  be  ob- 
served. 

The  situation  can  be  met  in  part  by  shifting  the  inspect- 
or's attention  from  the  refrigerator  cars  and  the  Wolff  Pack- 
ing Company  to  stores  and  markets.  Very  possibly,  however, 
there  is  more  work  than  can  be  handled  adequately  by  one  man 
alone.  The  inspector  should  be  given  more  liberal  financial 
treatment,  and  should  share  in  the  added  clerical  and  admin- 
istrative assistance  offered  by  a  more  liberally  financed  and 
more  closely  organized  city  health  department. 

AVELLS    AND    PRRaES 

A  careful  census  of  privies  and  wells  within  the  city  limits 
was  made  possible  b}^  the  co-operation  of  Commissioner  W.  Ij. 
Porter  and  the  city  sanitary  office.  Three  inspectors  made  a 
house-to-house  canvas,  listing  both  the  number  of  and  par- 
ticulars as  to  the  character  of  these  appurtenances.  The  re- 
sults of  this  inspection  are  tabulated  in  Tables  5  and  6,  and 
are  shown  graphicalh^  in  the  figures  opposite  pages  22  and  44. 

The  Privies. 

Four  types  of  privy  and  three  types  of  well  exist  in  To- 
peka.  The  wells  are  readily  classified  in  accordance  as  they 
are  driven,  drilled,  or  dug;  but  the  matter  is  somewhat  more 
complicated  with  the  privies,  there  being  besides  the  simple 
unconnected  vault,  a  few  "drawer"  closets  (which  are  in  prin- 
ciple similar  to  the  pail  closet),  a  considerable  number  of 
vaults  which  are  connected  Avith  the  sewer,  and  manj^  "tile" 
or  "hopper"  closets,  which  are  also  connected.  The  "tile" 
closets  occur  in  back  yards,  being  placed  over  the  main  house 
drain,  and  as  is  the  case  with  connected  vaults,  have  no  water 
flush.  In  both  cases  the  sanitary  advantage  gained  by  connec- 
tion is  but  partial.  Pollution  of  the  soil  is  avoided,  but,  there 
being  no  water  flush,  the  danger  from  fly-born  infection  is 
much  the  same  as  with  the  ordinary  form  of  priv}^ 

From  an  inspection  of  Table  5  it  is  evident  that  Topeka 
has  a  surprising,  even  startling,  number  of  privies.  Estimat- 
ing roughly  some  9,000  homes  in  the  city  it  appears  that  over 

46 


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three- fourths  of  the  people  are  privy  users,  and  this  despite 
the  fact  that  the  major  portion  of  the  city,  that  south  of  the 
river  and  west  of  Shunganunga  creek,  inchiding  over  70  per 
cent  of  the  poi^uhition,  is  equipped  with  a  fairly  complete 
sewer  system. 

The  east  side,  with  a  population  of  about  7,000,  which  we 
•have  seen  to  be  the  largest  without  servers  in  the  state  of  Kan- 
sas, accounts  naturally,  for  a  large  ]iumber  of  necessary  privies. 
Still,  taken  as  a  whole,  unsewered  districts  account  for  less 


THE    COMMON    PRIVY    AT    ITS 
WORST. 

Contents    entirely    unprotected,    with 

eveiy  opportunity  for  access  of 

flies  or  otlier  animals. 

than  half  the  privies;  while  M  per  cent  of  the  total  are  in 
places  where  both  sewers  and  city  water  are  already  in  the 
street.  Of  the  plain  unconnected  vaults  one-fourth  (1131) 
occur  in  sewered  districts,  and  nearly  one-fifth  (S66)  occur 
where  both  sewers  and  city  water  are  available. 

Such  a  state  of  affairs  is  certainly  inexcusable.  The  privy 
is  manifestly  a  makeshift  devised  for  country  life  and  is  in  the 
nature  of  things  not  suitable  for  the  more  crowded  city  condi- 
tions.    In  these  days  when  so  much  is  heard  regarding  the 

48 


danger  from  flies,  and  neces- 
sity for  STS'atting  them,  it 
must  be  remembered  that  the 
privy  IS  probably  the  great- 
est source  of  potential  fly 
danger.  Flies  of  tliemselves 
woukl  be  of  little  harm:  it 
is  their  ability  to  transport 
parts  of  the  discharges  of  a 
sick  person  to  some  one  else 
that  makes  them  a  sanitary 
menace:  and  their  principal 
opportunity  to  come  in  .con- 
tact with  these  infected  dis- 
charges is  in  the  open  privy. 


OTHER  TYPES  OF  PRIVY 
Above  a  "tile"'  or  "hop- 
per" closet:  below  a  "dra Av- 
er'' closet.  As  far  as  fly 
dangers  are  concerned  the 
"tile"  closet  presents  little 
advantage  over  the  common 
privy. 


Topeka  has  in  its  privies  one  of  the  primary  essentials  for 
fly  danger:  it  has,  as  well,  that  complimentary  essential — 
ample  opportunity  for  fly  breeding.  The  number  of  animals 
kept  within  the  city  limits  is,  according  to  the  County  Clerk's 
books,  as  follows : 

Horses 2,293 

Cattle 330 

Mules 127 

Dogs 1,392 

Hogs 35 

Sheep 1 

Goats 3 

Horse  manure  is  the  pre-eminent  fly  breeding  material, 

49 


and  considering  Topeka's  lack  of  provision  for  its  protection 
from  flies  and  its  sanitar}^  removal,  the  ample  opportunity  for 
fly  production  is  evident.  The  state  and  cit}^  health  depart- 
ments have  both  carried  on  vigorous  and  commendable  educa- 
tional campaigns  against  the  fly,  and  it  Avould  seem  that  the 
time  is  now  ripe  for  an  organized  city  attempt  to  eliminate  or 
control  the  great  fly-breeding  places.  Such  a  step,  coupled 
with  one  to  eliminate  its  unnecessary^  privies,  should  surely 
yield  the  city  a  real  hygienic  reward. 

The  Wells. 

Havhig  seen  the  great  number  of  privies  in  Topeka  it  is 
not  surprising  to  find  that  the  city  also  has  a  remarkable  num- 
ber of  wells.  More  than  half  the  homes  have  wells;  and  more 
than  half  the  Avells  are  at  places  where  city  water  is  in  the 
street.  These  facts  are  brought  out  in  Table  6  and  map  oppo- 
site page  44.    North  Topeka  and  the  east  side,  with  the  southern 


THE   PRIVY-WELL   COMBINATION. 

A  sample  of  very  close  connection;    sei^aration  about  10  feet.    Opportunity 

for  well   pollution  increases   with  the  number  of  privies   and   the 

shallowness  of  wells.     Examinations  in  some  districts  of 

the  city  showed  nine-tenths  of  the  wells  polluted. 

50 


B:^^7':: 


^^ 


ALONG  SHUNGANUNGA  CREEK. 
Xote  Yovr  of  privies  which  ensure  pollutiini   of  the  water.     Cliiklreii  fre- 
quently play  along  the  creek.     An  opportunity  to  turn 
a  menace  into  a  civic  asset. 

edge  of  the  city,  are  obvioush'  responsible  for  tlie  mass  of  tlie 
wells. 

Table  6.    Xumber  axd  Distribution  of  "Wells.  Topeka.  1913. 


Ward 

City  water       City  water 
not  available       available 

Total 

1 
2 
3 
4 
5 
6 

70S      ,       527 
924      j       863 
50             237 
14             274 
222             687 
162             264 

1235 
1787 
287 
288 
909 
426 

Totals... 

2080            2S52            4932 

As  in  the  case  of  the  pri^-y.  the  Avell  is  pre-eminently  a 
rural  institution.  In  the  city,  with  habitations  so  much  closer 
together,  the  chances  for  pollution  are  enormously  increased. 
Fortunately,  a  very  large  number  of  the  To])eka  wells  are 
driven  and  drilled,  the  type  not  so  easily  polluted.  If  such 
wells  tajo  good  strata,  which  bring  their  water  a  long  distance 

51 


from  the  cit}^,  the  water  Avill  probably  be  good;  even  so,  in  a 
city  of  Topeka's  size,  and  one  which  lias,  fnrthemore,  a  com- 
mendable municipal  water  supply  already  pretty  widely  dis- 
tributed, the  continued  use  of  wells  is  to  be  deprecated. 

Whatever  the  general  theorj^  regarding  the  unclesirability 
of  wells  in  an  urban  community,  we  have,  in  the  present  in- 
stance, considerable  specific  information.  Through  the  co-op- 
eration of  the  State  Board  of  Health,  the  University,  and  Prof. 
C.  C.  Young,  Director  of  the  State  Water  Survey,  it  was  found 
possible  to  analyze  an  unusually  large  number  of  samples  of 
Topeka  well  Avater.  All  samples  were  taken  in  sterilized  bot- 
.  ties,  refrigerated  \  and  shipped  to  Lawrence  to  undergo  bac- 
teriological examination.  Tests  ^  were  made  for  the  presence 
of  the  colon  bacillus  (the  typical  intestinal  bacterium),  as  well 
as  a  determination  of  the  number  of  organisms  developing  at 
blood  heat.  Altogether  samples  were  taken  from  some  1,673 
wells,  a  most  unusual  enterprise,  and  one  that  reflects  much 
credit  on  the  energy  of  Prof.  Young  and  his  associates  at  the 
University,  and  should  secure  for  them  the  city's  gratitude. 
The  resitlts  are  tabulated  in  the  table  below,  and  are  shown 
graphically  in  the  map  opposite  page  41. 

Results  or  Bacteriolooical  Exami]s^ation  of  Well  Water. 

Topeka,  1913. 

(Examinations  by  State  Water  Survey.) 


Ward. 

City    Water    not 
available 

City  Water 
available 

TOTAL 

Unpol- 
luted 

Pol- 
luted 

Unpol- 
luted- 

Pol- 
luted 

Unpol- 
luted 

Pol- 
luted 

Per  cent 
polluted 

1 
2 

3 
4 

0 

6 

141 

88 
6 

6 

7 

33 
276 

21 

31 
69 

164 

128 

7 

38 
17 

27 

362 

74 

69 
109 

305 
216 

13 

44 
24 

60 

638 

95 

100 

178 

16.4 

74.7 
88.0 

69.5 

88.0 

Totals 

248 

430 

354 

641 

602 

1071 

64.0 

Of  all  wells  examined  it  is  apparent  that  64  jier  cent 
showed  unmistakable  signs  of  pollution  of  intestinal  origin; 
and  this  is  a  percentage  which  holds  in  districts  where  city 
water  is  readily  available.  The  shoAving  of  different  parts  of 
the  city,  as  represented  by  the  figures  indicating  the  per  cent 

1  Through  the  courtesy  of  the  Seymour  Packing  Co. 

2  Presumptive  test  in  peptone  lactose  bile. 

52 


of  polluted  wells  in  the 
several  v/ards,  is  of  con- 
siderable interest.  The 
marked  relative  supe- 
riority^ of  the  wells  in 
North  Topeka  is  doubt- 
less due  in  large  meas- 
ure to  the  fact  that 
these  wells  are  practi- 
cally all  driven,  and  are 
said  to  penetrate  im- 
pervious strata,  taking 
their  water  from  good 
sandy  material  beneath. 
The  wells  examined  in 
Ward  2  are  said  to  be 
in  inferior  soils,  such 
as  gumbo  and  dai^k 
clay,  and  to  be,  further- 
more, mostly  of  the 
dug  variety,  so  that 
their  poor  show^mg  is 
in  no  Avay  surprising. 

The  existence  of  such 
a  large  number  of  wells 
in  the  city  and  the  ob- 
jectionable character  of 

many  of  them,  as  indicated  by  the  analyses,  represent  a  serious 
sanitary  problem  and  one  which  is  not  easy  of  practical  solu- 
tion. While  the  danger  is  not  as  great  as  might  be  at  first 
thought,  it  is  nevertheless  real.  A  person  hearing  for  the  first 
time  that  there  are  some  5,000  Avells  within  the  city  limits  and 
that  probably  two-thirds  of  these  are  polluted,  would  wonder 
that  serious  sickness  is  not  more  ]Drevalenl.  I'he  answer  to  such 
an  inquiry  is  that  ordinary  polhition  from  persons  in  good 
health  (or  from  other  warm-blooded  animals),  while  aesthet- 
ically objectionable,  is  probably  not  dangerous.  Only  when 
pollution  from  persons  suffering  from  intestinal  diseases  gets 
into  a  well  does  trouble  start.  Such  infected  persons  are,  for- 
tunately, relatively  rare,  and  the  opportunities  for  their  dis- 
charges to  enter  a  well  are  statistically  somewhat  small.     The 


A   DUG   WELL. 
Note    opportunity    for   pollution    at    sur- 
face of  the  ground.     For  city  use 
Ijrobably    tlie    most    insani- 
tary type  of  well. 


53 


PART  OF  THE  LARGEST  UNSEWEREU  COMMUNITY  IN 

KANSAS. 

In  East  Topeka,  looking  across  toward  tlie  Capitol. 

opportunity  exists,  however;  and,  realizing-  that  there  are  al- 
ways a  certain  number  of  persons  in  the  community  harbor- 
ing the  germs  of  intestinal  disturbances,  some  of  whom  may 
show  no  signs  of  disease,  we  know  that  in  accordance  with  the 
law  of  chance  a  few  wells  will  be  dangerously  polluted  from 
time  to  time.  The  chance  for  dangerous  pollution  (infection) 
varies  directly,  of  course,  with  the  number  of  wells.  These 
infections  give  rise  to  new  outbreaks  of  the  disease  in  ques- 
tion, and  so  form  the  basis  of  the  accepted  view  that  wells  are 
not  a  desirable  city  institution. 

If  further  evidence  be  desired  of  the  undesirability  of  the 
privy- well  combinaton,  it  may  be  had  by  looking  back  at  the 
figures  for  the  distribution  of  typhoid  fever  and  diarrhoea 
and  enteritis  on  page  11.  Exact  correspondence  cannot  be  ex- 
pected, as  the  figures  for  typhoid  are  somewhat  incomplete,  and 
the  character  of  the  wells  and  privies  vary  of  themselves;  it 
is  clear,  however,  that  there  has  been  a  good  general  corre- 
spondence between  the  number  of  wells  and  privies  and  the 
presence  of  these  intestinal  diseases. 

To  solve  this  combined  well  and  privy  problem,  the  city 
will  probably  find  it  best  to  set  up  restrictions  against  the  con- 
struction of  new  privies  and  wells;    to  provide  for  the  peri- 

54 


oclic  examination  of  existing  wells,  and  to  adopt  a  policy  of 
gradual  condemnation,  at  the  same  time  extending  the  city 
water  sj^stem;  and  to  force  connection  with  the  city  sewer  sys- 
tem. Such  a  program  is  the  more  easily  recommended  because 
of  the  good  character  of  the  cty  water  supply  and  the  already 
fairlv  extensive  and  too-little  used  sewer  system. 


OTHER    SANITARY    PROBLEMS 
TUBERCUI^GSIS. 

Compared  with  those  of  other  cities,  Topeka's  tuberculosis 
problem  is  not  of  the  first  magnitude ;  at  the  same  time  it  is  of 
the  first  magnitude  for  Topeka.  Resident  deaths  from  this 
cause  gave  the  citv,  in  1912.  a  death  rate  of  101  per  100,000 
population;  a  figure  which  compares  favorably  with  that  of 
most  large  cities — the  general  lack  of  crowding  and  the  char- 


AT    THE    TUBERCULOSIS    DISPENSARY. 

A  part  of  the  work  of  the  Anti-Tuberculosis  Association.     Persons   may 

come  to  the  Dispensary  for  treatment  and  instruction,  while  a  nurse 

visits  more  serious  cases  in  their  homes.     Such  work  is  legitimate   ' 

activity   for  the   city  health  department.     The   Dispensary    is 

located  in  the  Provident  Association  Building. 

55 


THE   HOME   OP   A  CASE   OP   TUBERCULOSIS. 
A  tuberculous  man,  his  wife,  and  two  cliildren  slept  in 
the   same  bed,  in  the  room  marked  X.     The  Anti- 
Tuberculosis    Association  built  the  tent  shown 
below,  and  now  the  man  lives  alone. 

acter  of  the  city's  population  both  tending  to  minimize  the  rav- 
ages of  this  ever-present  enemy  of  the  linman  race.  At  the 
same  time  47  deaths  occurred  from  the  disease  in  the  year  men- 
tioned, a  mortality  which,  according  to  the  usual  estimates,  rep- 
rents  a  body  of  three  or  four  hundred  cases.  The  truth  is  that 
tuberculosis  is  one  of  the  most  important  of  all  the  causes  of 
death,  and  is,  as  we  have  seen  in  our  discussion  of  vital  statis- 
tics (page  9),  perhaps  the  most  important  of  the  communic- 
able diseases,  and  is  of  especial  importance  in  certain  parts  of 
the  city  and  among  certain  peojjle. 


APTER     THE     ANTI-TUBERCULOSIS     ASSOCIA- 
TION HELPED. 
The  tent  built  by  the  Association.     More  healthful  ac- 
commodation for  the  man,  and  greatly  increased 
safety  for  the  children.    An  example  of 
constructive  work. 

56 


At  present  the  city  makes  no  effort  to  control  the  disease. 
Cases  are  reported,  in  accordance  with  the  state  hiw.  to  the 
health  anthorities;  a  record  is  made,  and  the  report  is  tran- 
scribed and  transmitted  to  the  State  Board  of  Health.  Xo  in- 
vestigation is  made  of  the  case,  no  steps  are  taken  to  see  that 
the  spread  of  infection  is  limited,  and  no  provision  is  made  to 
care  for  snfferers  from  the  disease.  Without  in  any  way  mini- 
mizing the  importance  of  proper  disinfection  after  tuberculosis, 
such  as  bv  Trashino-  and  srubbino-  with  disinfectino;  fluids  of 


THE   LOST   TUBERCULOSIS   CAMP. 

Opened  in  March.  1910,  in  Xortli  Topeka,  by  the  Anti-Tubereulosis  Associa- 
tion; closed  in  July,  1913,  as  a  result  of  protests  by  persons  in  adjoin- 
ing districts.    In  the  absence  of*  a  sanatorium,  as  in  Topeka,  such 
a   camp   can  do  much  useful  work.     Properly  maintained 
it  is  of  no  danger  to  the  neighborhood. 

known  strength,  it  is  fair  to  say  that  the  one  thing  which  the 
health  department  does  do,  i.  e.,  fumigation  after  death  or  re- 
moval, is  probably  of  slight  value. 

In  contrast  to  this  aspect  of  the  situation,  it  is  gratifying 
to  see  that  private  philanthropy  has  taken  the  initiative  and  is 
illustrating  the  course  of  action  which  the  city  in  all  probability 
will  eventually  adopt.  The  Topeka  Association  For  the  Study 
and  Prevention  of  Tuberculosis  now  maintains  a  free  clinic  to 
which  sufferers  mav  come  for  examination  and  treatment,  and 


provides  a  visiting  nurse  to  go  about  among  the  homes  and 
advise  and  assist  in  the  care  of  the  patient  and  of  other  mem- 
bers of  the  family.  This  is  good,  solid,  preventive  work,  simi- 
lar to  that  carried  on  by  our  best  city  health  departments. 
Such  a  program  of  investigation  and  education  protects  other 
members  of  the  family,  and  especially  children,  from  infection, 
and  prevents  suffering  and  death.  The  work  of  the  anti-tuber- 
culosis association  has  the  support  and  co-operation  of  the 
State  Board  of  Health,  and  desrves  every  encouragement. 

The  lack  of  sanatorium  facilities  for  the  treatment  of  tu- 
berculosis should  be  noted  before  finishing  our  discussion  of 
this  disease.  At  present  absolutely  no  such  facilities  exist— a 
relatively  primative  condition.  Some  relief  will  probably  be 
obtained  from  the  projected  state  sanatorium,  but  Topeka's  al- 
lowance in  this  will  almost  surelv  be  inadequate  as  compared 
with  her  proper  needs,  and  she  Avill  do  well  to  consider  other 
means  of  meeting  the  situation.  The  estimate  of  the  New  York 
State  Commission  on  Public  Health  allowed  one  bed  for  each 
yearly  death ;  on  this  basis  Topeka  would  need  about  fifty  beds. 


FREE   DENTAL   DISPENSARY. 
Maintained  at  the  Provident  Association  building  by  Shawnee  Dental 

Association. 


INFANT    MORTALITY. 

A  baby  brought  to  the  Free  Baby  Hospital  suffering  from  malnutrition. 

but   too   late   to    save.     Active   city   health  departments,    through 

nurses  and  baby  welfare  stations,  are  preventing  much  of 

this  kind  of  sickness  and  death. 

One  helpful  method  of  attacking  this  pha-e  of  the  problem  is 
through  a  suitable  day  or  night  camp  in  the  outskirts  of  the  city. 
Such  a  camp  was  provided  and  maintained  by  the  anti-tuber- 
culosis association,  with  the  support  of  the  city,  for  a  time  in 
Xorth  Topeka.  Objections  on  the  part  of  residents  of  the  neigh- 
borhood finally  closed  the  camp.  AVe  may  simply  state,  in  this 
connection,  that  a  proj^erly  maintained  camp,  sanatorium,  or 
hospital  need  be  no  danger  whatever  to  even  it-  quite  iimne- 
diate  neighborhood,  and  that  it  is  tmfortunate  if  groundless 
fear  of  such  an  institution  be  allowed  to  prevent  such  mtich- 
needed  work. 


Infant  ^Moktality, 

The  city's  infant  death  rate.  96  per  I.ijOO  Ijirth-  in  l'.il2. 
is  not  a  high  one :  but  we  have  seen  that  it  shows  marked  varia- 
tions in  different  parts  of  the  city,  being  nearly  twice  as  high 
in  Xorth  Topeka  and  the  east  side  as  in  the  Third  and  Fourth 
wards.  This  means  simply  that  for  a  given  number  of  babies 
born,  nearly  twice  as  many  died  before  reaching  the  age  of  one 
in  the  First  and  Second  wards  as  in  the  Third  and  Fourth.  The 
incidence  of  diarrhoea  and  enteritis  among  infants  we  have  also 
seen  to  be  relatively  much  greater  in  the  first  districts  as  com- 
pared with  the  last  two. 

This  variation  of  infant  mortality  in  accordance  with  liv- 
ing   conditions    is    generally    recognized,    and    has    generally 

59 


yielded  to  simple  administrative  procedures.  The  more  par- 
ticular causes  of  this  mortalit^^  and  the  age  at  death  are  indi- 
cated in  the  table  on  the  opjDOsite  page. 

The  heaviest  mortality  evidently  occurs  in  the  earliest  age 
periods — 18.6  per  cent  of  it  on  the  first  day;  another  15  per 
cent  in  the  rest  of  the  first  week,  and  a  total  of  53.5  per  cent 
in  the  first  month.  Of  the  causes  listed,  the  first  four,  whoop- 
ing cough,  tuberculosis,  broncho-pneumonia,  diarrhoea  and  en- 
teritis, causing  33  deaths  (43.5  per  cent  of  the  total),  are  re- 
garded as  largely  preventable,  with  a  portion  of  the  "diseases  of 


A   CORNER   OF   THE    FREE    BABY   HOSPITAL. 

At  the  Provident  Association.    Anotlier  constructive  work  by  private  pliil- 

antliropy.     Sick  infants  are  cared  for  during  the  liot  summer  months. 

early  infancy"  to  be  contested  for.  Substantial  reductions  in 
this  kind  of  infant  mortality  have  been  achieved  in  a  number 
of  cities  by  establishing  infant  welfare  stations  to  which  babies 
may  be  brought,  and  by  sending,  in  the  centers  of  the  trouble, 
educational  nurses  among  the  homes.  Unhygienic  liAdng  by 
mothers  before  the  birth,  excessive  summer  temperatures,  and 
improper  care  and  feeding  of  the  infants  are  important  factors 
in  causing  the  mortality ;  and  are  ones  with  which  the  properly 
trained  public  health  nurse  is  best  qualified  to  cope.  Topeka 
may  be  confident  that  for  a  few  hundred  dollars  a  year  ex- 

60 


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61 


pended  in  these  ways,  a  number  of  babies  could  be  saved,  and 
the  health  of  other  infants  much  improved. 

Here  again  private  ^philanthropy  has  been  quicker  to  re- 
spond to  a  need  than  the  city  authorities.  The  Provident  As- 
sociation has,  during  the  past  summer,  maintained  a  free  dis- 
pensary and,  on  a  small  scale,  a  baby  hospital.  The  illustra- 
tions indicate  the  general  character  of  the  Avork.  Much  good 
has  undoubtedly  been  accomplished  in  this  way,  and  further 
advantage  would  be  gained  with  a  nursing  service  extended 
into  the  babies'  homes. 

Venereal,  Diseases. 

The  venereal  diseases — chancroid,  syphilis  and  gonorrhoea, 
are  infectious,  communicable,  and  preventable.  Caused  by  spe- 
cific micro-organisms,  the  are  responsible  for  much  suffering, 
loss  of  efficiency,  and  premature  death  in  middle  age.  In 
most  cities  they  are  relatively  widespread — in  all  probability 
the  most  prevalent  of  all  serious  communicable  diseases.  At  the 
same  time  marked  progress  has  been  made  in  the  last  few  years 
in  their  treatment  and  prophylatis. 

Reasonably  accurate  information  as  to  the  prevalence  of 
these  diseases  in  Topeka  is,  as  in  most  cities,  very  difficult  to 
obtain.  Reports  of  the  diseases  are  not  required  by  the  health 
authorities  and  the  only  dispensary  records  which  would  shed 
light  on  the  subject,  those  of  the  discontinued  Washburn  Dis- 
pensary, are  confessedly  inaccurate.  No  reason  exists,  however, 
to  doubt  that  Topeka  has  its  normal  share  of  the  diseases,  re- 
sponsible persons  being  found  who  believed  even  that  the  city 
has  an  excess.  One  well  informed  man  stated  that  in  his  par- 
ticular trade  he  had  never  had  a  helper  who  did  not  have  one 
of  the  diseases  at  some  time  or  other. 

At  all  events,  organized  activity  against  these  diseases 
would  undoubtedly  be  an  exceedingly  valuable  service  to  the 
community.  In  the  largest  cities  the  health  authorities  are  com- 
ing to  require  the  reporting  of  these  diseases  in  the  same  man- 
ner as  the  other  dangerous  communicable  diseases  (by  number 
instead  of  name,  if  desired),  by  offering  free  laborator}^  diag- 
nostic facilities,  and  by  offering  free  treatment  to  indigent  suf- 
ferers— at  the  same  time  making  the  service  such  as  will  at- 
tract and  secure  confidence.    These  rational  measures  are  rec- 

62 


ommendecl  to  Topeka,  and  it  is  doubtful  if  her  health  depart- 
ment can  perform  a  more  valuable  service  than  to  put  our  mod- 
ern knowledge  of  these  diseases  into  practical  use. 

Housing. 

In  the  time  available  it  was  found  impossible  to  make  any 
detailed  survey  of  housing  conditions  in  the  city.  Through  the 
co-operation  of  State  Hotel  Commissioner  Mulroy,  however,  it 
was  possible  to  have  considerable  work  done  on  the  condition 
of  rooming  houses,  apartments,  hotels,  and  restaurants.  Alto- 
gether some  sixty  places  were  visited,  and  numerous  orders 
were  given  for  improvement.  The  data  as  to  the  conditions 
found  are  summarized  below  : 


Inspectiox   of  Hotels,  Roo]mixg  Houses,  Apartments  and 

Restaurants,  Topeka,  1913.^ 

(Figures  furnished  by  State  Hotel  Commissioner.) 


Hotels 

Room- 
ing 
houses 

Apart- 
ment 
houses 

Res- 
tau- 
rants 

Totals 

No.  places  visited .  . . 

17 

14 

5 

24 

60 

Insanitary    yards. .  . . 

Insanitary  toilets .  . . 

Insufficient    toilets.. 

Insanitary    bedding. . 

Insanitary   kitchens . 

Insanitary  cellars .  . . 

Insufficient    fire    ex- 
tinguishers  

Insufficient    fire    es- 
capes  

Insufficient  lighting. 

Inside  rooms.. 

Insanitary  wash 
rooms 

4 
2 
1 
2 

1 
1 

3 

2 
2 
1 

2 

4 
4 
3 
4 
0 
0 

2 

2 
3 
2 

2 

2 

1 
0 
0 
0 

1 

3 

1 
0 
0 

0 

3 
3 

8 
0 

4 

2 

0 

0 
0 
0 

4 

13 

10 

12 

6 

5 

4 

8 

5 
5 
3 

8 

Total      unsatisfac- 
tory  items 

21 

26 

8 

24 

79 

The  rooming  houses  have  manifestly  come  off  worst  in 
this  inspection;  of  the  defects  found  the  most  prominent  are 
insanitary  yards  and  insufficient  and  insanitary  toilets.  Over- 
crowding and  grossly  insanitary  conditions  were  easily  found 
in  apartment  houses  where  the  rents  extracted  would  seem  to 

1  This  does  not  include  all  of  the  places  in  Topeka  but  only  the  ones 
visited  up  to  this  time,  which  is  probably  three-fourths  of  such  places. 

63 


warrant  a  much  larger  portion  of  decency.  The  photographs 
will  give  an  idea  of  these  and  some  of  the  other  existing  hous- 
ing conditions. 

Altogether  it  is  evident  that  there  is  need  in  Topeka  for  a 
housing  law.  Certainly  in  ]:)lanning  for  the  bigger  Topeka  it 
will  be  prudent  to  give  careful  investigation  to  existing  housing- 
conditions,  and  to  create  such  regulations  as  will  remedy  exist- 
ing evils  and  prevent  the  development  of  new  ones. 

Refuse  Disposal. 

Collection  and  disposal  of  garbage  is  a  matter  Avhose  sani- 
tary importance  is  very  commonly  exaggerated.    As  far  as  fly 


ROOM   OVERCROWDING  IN  TOPEKA. 
This  room,  ■with  two  small  windows  which  would  not  open,  served  as  bed- 
room and  living  room  for  a  family  of  four. 

breeding  is  concerned,  manure  is  probably  of  much  greater  im- 
portance ;  while  the  possibility  of  danger  from  any  infectious 
material  in  garbage  is  undoubtedly  ver}^  slight.  The  matter  of 
refuse  disposal  is  at  the  same  time  intimately  related  to  civic 
cleanliness  and  decency,  attributes  which  have  a  reflex  effect 
upon  health.  While  therefore  an  extended  iuA^estigation  of 
refuse  disposal  in  Topeka  has  not  seemed  justified  under  the 

64 


RUDIMENTARY  HOUSING   IN  TOPEKA. 

This  house  is  set  in  a  dug-out  foundation  and  replaces  an  abode  made  of 

window  blinds  which  are  now  used  for  a  shed  in  the  rear. 


A  DIRTY  BACK  YARD. 

Showing  opportunities  for  pollution  of  well  by  surface  water. 

65 


RUNWAY  IN  REAR  OF  TENEMENT  HOUSE. 
The  pnly  uncovered  area  on  a  lot  occupied  by  a  three-storj^  building. 

time  limitations  of  the  present  surA^ey,  a  brief  review  of  the 
question  may  be  permitted. 

The  city  refuse  collection  is  luider  the  general  direction  of 
the  Commissioner  of  Parks  and  Public  Property,  the  equipment 
consisting  of  three  garbage  wagons,  two  manure  wagons,  and  a 
garbage  crematory.  Garbage  is  collected  tAAice  a  week,  and 
trash  as  required.  Tin  cans  and  ashes  are  collected  once  a  year, 
when  the  Street  Commissioner  has  a  "Tin  Can  Week,"  and  re- 
moves such  material  to  low  places  about  town.  Two  city 
dumps,  one  west  of  the  cremator}^  and  one  on  South  Kansas 
avenue,  are  maintained,  as  well  as  a  few  ]Drivate  ones. 

While  Topeka  has  thus  a  garbage  collection  system  and  a 
pretentious  crematory,  the  service  is  entirely  optional,  the  scale 
of  charges  being  40  cents  for  one  10  gallon  can  and  60  cents 
for  one  20  gallon  can  per  month.  Altogether  about  600  persons 
avail  themseh^es  of  the  garbage  service,  while  275  patronize  that 
for  manure.  In  North  Topeka  there  are  only  something  like  a 
dozen  customers.  Many  keep  chickens  and  other  animals,  while 
others  dispose  of  their  garbage  to  private  slop-haulers.  The 
latter  are  under  city  supervision  and  pay  a  small  fee.    Even  the 

66 


most  cursor}-  inquiry  makes  it  wholly  apparent  that  the  city 
garbage  collection  system  is  very  partial,  and  that  but  small 
use  is  being  made  of  the  capacity  of  the  crematory. 

Physical  Examixatiox  of  School  Childrex. 

A  thorough  investigation  of  school  hygiene  in  Topeka  was 
not  included  in  the  Public  Health  Survey  because  of  the  limita- 
tions as  to  time  and  assistance.  It  was  found  possible,  however, 
through  the  generous  co-operation  of  T)rs.  W.  M.  Mills,  M.  G. 
Sloo,  M.  B.  Miller.  F.  L.  Loveland.  and  Supt.  of  Schools 
H.  B.  AVilson,  to  make  physical  examinations  of  216  children. 
It  should  be  noted,  of  course,  that  a  careful  survey  of  the  sani- 
tary condition  of  the  school  plant  is  highly  desirable,  and  that 
such  an  undertaking,  which  the  school  board  now  has  under 
consideration,  is  to  be  heartily  endorsed. 

In  the  examination,  as  carried  out,  four  schools  were  se- 
lected in  representative  parts  of  the  city,  the  children  being 
taken  mostly  from  the  third  and  fourth  grades,  a  few  from  the 
fifth  grade.  Prior  to  the  examinations  a  notice  was  sent  to 
parents,  outlining  the  plan,  and  asking  permission  to  examine 
their  children.    Xo  difficulty  was  encountered  in  ol)taining  per- 


PRIMITIVE   SANITATION — -'EPIDEMIC   ROW." 

An  alley  lined  with  privy  vaults  and  private  wells.    Note  tlie  piles  of 

fly-breeding  manure. 

67 


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mission,  and  nt)  attt'iii|)t  ^va-  maile  to  select  defective  cliildren. 
The  results  of  the  work  are  indicated  on  the  opposite  page. 

These  findings  accord  in  general  Avith  tlio-e  obtained  in 
other  parts  of  the  country.  The  commonest  defects  are  obvi- 
ousIt  those  of  the  teeth,  including  irreguharities  and  decar.  and 
those  of  the  breathing  passages — usually  enlarged  tonsil>  and 
adenoids.  The  relative  sho^vings  of  the  four  schools  are  not  ex- 
actly what  might  have  been  expected.  The  large  ntunber  of 
defects  among  children  in  the  Central  Park  School,  which  is 
situated  in  a  district  where  excellent  living  conditions  and  good 
medical  ser\"ice  woidd  be  expected  to  ]3revail.  is  rather  stirpris- 
ing.    The  matter  i-  evidently  not  one  concerning  only  the  poor. 

The  more  particular  nature  of  the  defects  found  is  as  fol- 
lows: 

Xattke  or  Defects  P'ouxd. 

Vision —  Teeth — 

Disease 4  Decay 99 

Xear    sight 18  Irregularities 58 

Astigmatism 2  Cardiac  disease 4 

Hearing —  Malformations — 

Disease  of  ear 6  Congenital 1 

Discharge  from  ear 6  From  abnormal  positions ....     2 

Breathing  passages —  Acute  or  chronic  inflammation     1 

Adenoids 35  Malnutrition 13 

Enlarged   tonsils 116  Other 5 

Elongation  of  uvula 14  

Enlarged    glands 94  Total 478 

The  lesson  of  this  test  examination  is.  of  course,  the  very 
considerable  niunber  of  children  found  with  ea:^ily  correctable 
defects,  which  in  the  large  majority  of  instances  were  previotis- 
ly  unrecognized  and  were  tmdergoing  no  treatment.  It  has 
been  shown  that  these  defects  have  very  real  effects  on  the  ac- 
tivity ami  future  welfare  of  tlie  child,  and  are  a  severe  handi- 
cap to  its  progrer^s. 

Realization  of  the  .-eriousnes-  of  such  a  .-situation  har-  in- 
duced practically  all  the  large  cities  to  institute  careful  and 
systematic  examination-  of  all  school  children.  Parents  are  no- 
tified of  the  defects  found  and  are  advised  to  have  the  condi- 
tions remedied:  while  nurses  are  employed  to  follow  up  cases 
in  the  poorer  home-  to  help  obtain  proper  treatment  for  the 

69 


child.  Here  surely  is  a  situation  where  an  ounce  of  prevention 
in  childhood  is  worth  its  pound  of  cure  to  the  adult,  a  fact 
which  is  now  pretty  universally  recognized,  and  one  which  To- 
peka  cannot  afford  longer  to  ignore.  To  deprive  its  future  citi- 
zens of  what  is  a  fundamental  necessity  is  unfair  and  unwise. 
By  hiring  a  school  nurse  the  school  authorities  have  made  a 
start;  it  is  a  step  in  the  right  direction,  but  cannot  of  course 
take  the  place  of  careful  physical  examinations  by  competent 
i">hysicians. 

Such  a  systematic  examination  system  is,  at  the  same  time, 
an  added  protection  against  contagious  diseases;  in  the  control 
of  which  early  recognition  and  isolation  of  incipient  cases  is  of 
prime  importance.  In  the  test  examination  described  above, 
two  cases  of  trachoma,  a  serious  contagious  disease  of  the  eye, 
were  found  in  the  Quincy  School.  This  disease  is  difficult  to 
cure  and  dangerous  to  the  eyesight,  often  resulting  in  complete 
blindness ;  it  is  communicated  by  personal  contact,  and  the  use 
of  common  towels  and  the  like.  The  symptoms  in  the  early 
stages  are  simple  reddening  of  the  eye  or  inflammation  of  the 
eye  lids.  The  undetected  presence  of  such  a  disease  among 
school  children  is  a  matter  the  seriousness  of  which  is  obvious ; 
as  is  the  argument  such  a  condition  makes  for  a  regular  and 
systematic  examination  of  all  the  children. 


70 


III.  THE  LOCAL  HEALTH  DEPARTMENT 

Oeganiza  tiox. 

V.liile  the  exact  form  of  the  city's  public  health  work  is 
somewhat  vague,  its  general  form  is  as  outlined  below : 

Presext  Orgaxizatiox  of  Topeka's  PrBiJC  Health  Wopk. 


Commissioner   of 
Parks  and  Public  Property 

Board  of  Health      | 

1       City  Physician 

\ 

/ 

Sanitary    Department    Detention   Milk             Food  and     Plumbing 
i                        Hospital      Inspector    weights       Inspector 

1   Sanitary   Sergeant              |                                inspector 

1                       ^Matron 
2   (Sanitary   Policemen 

A  kind  of  triple-headed  directorate  exists,  the  board  being 
exjDected  to  direct  the  sanitary  sergeant  and  the  city  physician 
in  a  general  way  and  to  regulate  quarantine,  while  the  city 
physician  is  responsible  for  the  detention  hospital  and  the  gen- 
eral supervision  of  communicable  diseases.  The  actual  man- 
agement of  the  work  rests,  however,  with  the  Commissioner  of 
Parks  and  the  Sanitary  Sergeant.  The  Board  of  Health  con- 
sists of  five  members,  including  the  Commissioner  of  Parks, 
Commissioner  of  Streets  and  the  city  physician ;  it  meets  at  the 
call  of  the  secretary  (the  city  physician)  and  passes  such  reso- 
lutions as  may  seem  necessary.  At  the  time  of  the  Survey  it 
had  met  once  in  the  last  six  months. 

The  city  jDhysician  is  engaged  chiefly  with  treating  pris- 
oners at  the  city  jail,  emergenc}^  cases,  and  the  poor  in  cases  of 
contagious  disease.  Members  of  the  city  fire  and  police  depart- 
ments are  entitled  to  his  services  free,  and  the  detention  hos- 
pital for  smallpox  is  also  placed  in  his  care:  jail  and  police  de- 

71 


partment  work,  however,  account  for  tliree-fourths  of  his  city 
service,  requiring  daily  visits  to  tlie  jail.  The  city  physician  is 
appointed  by  the  Commissioner  of  Parks  for  two  years,  and  re- 
ceives a  salary  of  $G0  a  month. 

The  Commissioner  of  Parks  under  the  Topeka  Commission 
Form  of  government  is,  of  course,  an  elective  officer;  and  in 
addition  to  the  sanitary  department,  is  responsible  for  the  city 
refuse  collection  and  the  crematorj^  the  city  parks,  and  all  city 
projDerty — such  as  the  Auditorium. 

The  deficiencies  in  the  present  organization  are  readily 
discoverable.  The  most  glaring  defect  is  the  utter  lack  of  any 
trained  and  exiDcrienced  health  officer — a  fact  of  which  the 
Commissioner  of  Parks  is  keenly  appreciative.  The  city  em- 
ploys no  person  who  is  competent,  and  whose  duty  it  is,  to  re- 
view the  work  of  the  milk  inspector,  or  of  the  food  inspector, 
or  to  lay  out  the  new  work  which  is  needed  in  other  directions. 
The  sanitary  sergeant  is  undoubtedly  an  excellent  administra- 
tive officer  as  far  as  his  department  is  concerned,  and  the 
present  Commissioner  of  Parks  an  active  and  progressive  man ; 
but  neither  would  lay  claim  to  the  qualifications  of  the  modern 
health  officer.  Present  day  health  departments  are  no  longi.>r 
mere  nuisance  abatement  offices,  and  their  efficient  operation 
calls  for  the  specially  qualified  man. 

Financial  Treatment. 

Other  defects  in  the  city's  health  organization  relate  to 
omissions  from  its  program,  such  as  the  already-discussed  work 
against  tuberculosis  and  infant  mortality.  These,  as  well  as  the 
defects  in  organization  above  noted,  are  m  a  large  measure  due 
to  the  city's  false  economy  in  the  matter  of  health  work,  as  will 
be  evident  from  a  brief  inspection  of  the  department's  finan- 
cial resources,  which  are  indicated  on  the  opposite  page. 

The  total  expenditure  on  behalf  of  the  Sanitary  Depart- 
ment— $10,131.77 — rej^resents  a  yearly  expenditure  of  21.1  cents 
for  each  inhabitant.  Limiting  our  figure  to  more  strictly  pre- 
ventive work  by  disregarding  expenditures  for  weed  cutting 
and  plumbing  inspection,  it  falls  to  17.5  cents.  If  further  al- 
lowance is  made  for  the  fact  that  the  city  physician's  Avork  is 
almost  entirely  (say  two-thirds)  poor  relief,  and  for  the  fact 
that  the  city  obtains  a  revenue  of  over  $2,400  a  year  from  food 

72 


EXPEXDITURES   OF   ClTl"   SAXITARr   DePAETME>T.    ToPEKA.    1913. 


Salaries — 

City  physician 

Sanitary    sergeant 

Three   sanitary    policemen. 

Fumigator 

^Matron   Detention    Hospital 

INIilk   inspector 

Food    inspector 

Plumbing    inspector 

Other 


Expenses  of  Detention   Hospital. 

Expenses  of  milk   inspector 

Expenses  of  plumbing    inspector. 

Expenses  of  food   inspector 


Expenses  of  Sanitary  Department- 
Cutting    weeds 

Labor 

Printing 

Board  of  Health  meeting 

Merchandise 

Fumigating  and  other  materials 
Miscellaneous 


S    720.00 

780.00 

2,160.00 

840.00 

600.00 

1,200.00 

900.00 

1,200.00 

28.03 

231. .52 

102.00 

125.00 

53.12 


421. .59 

19.00 

8.00 

5.00 

3.47 

CI  0.58 

124.46 


.$  8,428.03 


511.64 


1,192.10 


Total. 


$10,131.77 


inspection  fees,  the  figure  dro]j.~  to  ll.-">  cents  per  inhabitant  per 
year.  That  such  an  expenditure  is  inadequate  for  a  modern 
healtli  department,  one  equipped  to  take  advantage  of  demon- 
strated opportunities,  is  well  known.  In  the  table  on  the  next 
page  comjoarable  expenditures  are  given  for  cities  with  poiDula- 
tions  of  between  50.000  and  100.000. 

Topeka  ranks  eighteenth  in  this  list  of  thirty  cities  of 
similar  size  and  it  must  be  remembered  that  the  expenditures 
of  the  other  cities  are  by  no  means  ideal.  Most  of  them  are  in 
fact  wholly  inadequate,  persons  atIio  have  given  the  subject 
special  study  having  recommended  tliit  a  well-rounded  health 
department  be  allowed  a  minimum  pm-  capita  expenditure  rang- 
ing from  50  cents  to  $1.00. 

The  plain  fact  is  that  Topeka  cannot  do  its  public  health 
duty  to  its  citizens  without  liberally  increasing  the  health  de- 
partment's financial  allowanc".    Even  so.  the  increase  and  total 


Municipal  Health  Depart:\ient  Expenditures.^ 


City 

Popula- 
tion 

Amount 
per  year 

Per 

capita 

1.  Yonkers 

2.  Springfield,  Mass 

3.  Tacoma 

4.  Lynchburg 

5.  Elizabeth 

79,000 
88,000 
83,000 
89,000 
73,000 
53,000 
98,000 
78,000 
96,000 
52,000 
58,000 
66.000 
56,000 
69,000 
77,000 
51,000 
58,000 

47,980 

51,000 
66,000 
73,000 
64,000 
82,000 
96,000 
96,000 
94,000 
52,000 
55,000 
70,000 
53.000 

$45,099 
39.985 
28,045 
29,637 
23.068 
16,000 
25,500 
20,000 
22.500 
10,920 
12,100 
13,500 
10,763 
13,200 
14,300 
9,000 
10,000 

7,905 

8,335 

10,365 

11,000 

9,118 

10,000 

11,575 

9,500 

8,965 

4,330 

3,100 

2,600 

2,000 

$.570 
.454 
.337 
.333 
.316 
.301 
.260 
.256 
.234 
.210 
.208 
204 
.192 
.191 
.185 
.176 
.172 

.165 

.163 
.157 

.150 
.142 

.121 
.120 
.098 
.095 
.083 
.056 
.037 
.037 

6.  Covington 

7.  Hartford 

8.  Duluth 

9.  New  Bedford 

10.  Wichita 

11.  Portland,  Me 

12.  Peoria 

13.  Brockton 

14.  Evansville 

15.  Somerville 

16.  Mobile 

17.  East  St.  Louis 

18.  TOPEKA 

19.  Springfield,  111 

20.  Erie 

21.  Waterbury 

22.  Harrisburg 

23.  Kansas  City,  Kan 

24.  Trenton 

25.  Reading 

26.  Camden 

27.  Altoona 

28.  Bayonne 

29.  Hoboken 

30.  South  Bend 

expenditure  advocated  are  in  reality  very  small.  If  the  present 
expenditure  be  trebled,  it  will  only  represent  an  outlay  of  50 
cents  for  each  inhabitant  each  year,  and  will  still  be  only  1.9 
per  cent  of  the  total  municipal  expenditure  and  7.3  per  cent  of 
the  money  now  allowed  for  police  and  fire  protection. 

Inspection  Service, 
The  sanitary  inspectors,  three  in  number,  placard  conta- 
gious diseases,  investigate  complaints,  and  inspect  privies,  ma- 
nure pits,  and  nuisances.  For  this  purpose  the  city  is  divided 
into  three  districts;  the  first  including  wards  1  and  2  (east 
and  north)  ;  the  second  wards  4  and  6  (west)  ;  and  the  th^rd 
wards  3  and  5  (south).  Each  inspector  keeps  to  his  own  dis- 
trict and  is  made  responsible  for  conditions  in  it.    In  the  time 

1  For    directly    preventive    work ;     expenditures    for   general    hospitals, 
refuse  disposal,  street  cleaning  and  plumbing  inspection  not  included. 

74 


available  no  attempt  could  be  made  at  a  thorough  investiga- 
tion of  the  efficiency  of  this  service ;  but  it  is  evidently  carried 
out  under  careful  and  conscientious  direction.  A  commendable 
campaign  against  flies  during  the  last  year  may  also  be  men- 
tioned to  the  credit  of  the  sanitary  sergeant. 

The  inspection  given  milk  and  other  foods  having  been 
already  discussed  at  length  in  other  parts  of  this  report,  it  is 
necessary  at  this  point  only  to  re-emphasize  the  very  serious 
shortcomings  which  exist  in  these  two  important  services. 

Control  or  Communicable  Diseases. 

The  control  of  communicable  diseases  is  theoretically  under 
the  supervision  of  the  city  physician ;  actually  the  work  is  car- 
ried out  by  the  sanitary  sergeant.  Eeports  from  physicians  are 
required  of  a  satisfactory  list  of  diseases,  including  tubercu- 
losis, typhoid  fever,  scarlet  fever,  diphtheria,  measles,  whoop- 
in  o^  cough,  chicken  pox,  smallpox,  cerebrospinal  meningitis  and 
mumps.  Smallpox,  scarlet  fever,  diphtheria  and  tuberculosis 
would  seem  to  be  fairly  well  reported,  an  exact  idea  being  diffi- 
cult to  obtain  because  the  death  registration  was  incomplete 
until  the  fall  of  1911  and  no  records  of  cases  were  kept  until 
August,  1913.  The  other  diseases,  with  the  possible  exception 
of  typhoid  fever,  are  probably  reported  with  very  little  com- 
pleteness. The  reporting  of  cases  is  of  prime  importance  in  the 
control  of  contagious  diseases,  and  it  is  hoped  that  vigorous  ef- 
forts will  be  put  forth  to  malce  the  reports  as  full  as  possible. 
For  a  physician  to  refrain  from  reporting  a  case  of  contagious 
disease  is  a  very  mistaken  kindness,  both  to  the  family  in  which 
the  case  occurs  and  to  neighbors. 

The  quarantine  regulations  are  laid  down  by  the  Board  of 
Health  and  confirmed  by  the  city  commissioners.  In  scarlet 
fever,  diphtheria,  measles  and  chicken  pox  the  house  is  pla- 
carded by  a  sanitary  policeman,  and  printed  instructions  are 
left  as  to  the  care  of  the  case.  Further  inspection  is  made  only 
in  the  case  of  diphtheria  and  scarlet  fever,  in  which  diseases  the 
city  physician  makes  a  final  visit  to  lift  the  quarantine.  In 
these  two  diseases  wage  earners  must  live  outside  the  premises. 
Notice  of  all  contagious  diseases  is  telephoned  to  the  school  de- 
partment but  no  individual  notification  is  given  milk  men  or 
the  public  library. 

75 


Id  cases  of  typhoid  fever  and  tuberculosis,  at  the  time 
of  the  Survey,  no  steps  were  taken,  which  is  unfortunate.  Ty- 
phoid is  considerably  more  contagious  than  is  generally  under-' 
stood,  and  proper  instruction  in  bedside  disinfection  is  of  much 
value  in  preventing  secondary  infection  of  those  associated 
with  the  patient.  In  tuberculosis,  as  w^e  have  seen,  the  lack  of 
follow^  up  W'Ork  bv  the  city  authorities  is  also  unfortunate,  al- 
though the  situation  is  somewhat  relieved  by  the  work  of  the 
anti-tuberculosis  association.  Here  are  opportunities  to  pro- 
tect the  public  health,  much  more  definite  and  valuable  than 
those  represented  by  w^eed-cutting  and  nuisance  abatement ;  yet 
they  are  passed  oyer,  and  probably  will  continue  to  be  passed 
over  until  the  city  secures  a  full-time  health  officer. 

Another  serious  handicap  to  Topeka's  efforts  to  control 
contagious  diseases  is  the  lack  of  any  facilities  for  their  hos- 
pital care.  While  at  first  doubtful  of  the  need  for  a  contagious 
hospital,  feeling  that  it  might  be  difficult  to  get  people  to  use 
it,  the  city  plwsician  stated  that  he  had  seen  cases  needing  hos- 
pital care  that  none  of  the  existing  hospitals  would  probably 
take.  A'fter  some  consideration  he  suggested  that  it  might  be 
practicable  if  the  county  won  Id  co-operate,  and  expressed  the 
opinion  that  it  W'Ould  probably  prevent  a  good  deal  of  conta- 
gion and  would  make  things  easier  for  doctors. 

Very  few  cities  find  they  can  do  wdtliout  hospital  facilities 
for  these  diseases.  Cases  are  bound  to  occur  in  crowded  homos 
where  proper  isolation  cannot  be  maintained,  and  where  conta- 
gion will  inevitably  spread.  There  are  also  cases  in  Avhich  the 
sickness  is  so  serious  that  proper  hospital  treatment  decides  the 
issue  as  betw^een  life  and  death.  For  these  reasons  the  advisa- 
bility of  making  some  provision  is  earnestlj^  suggested.  The 
facilities  should  be  made  attractive,  that  they  may  be  used  wiii- 
ingij^,  and  modern,  that  they  may  allow  every  advantage  in 
treatment.  The  report  of  the  New  York  State  Commission  on 
Public  Health  recommended  that  the  allowance  of  such  beds  in 
a  community  be  not  less  than  one  to  each  2,000  of  population ; 
on  this  basis  Topeka's  quota  w^ould  be  about  twenty-five. 

Regarding  laboratory  diagnosis  and  free  anti-toxin,  To- 
peka  is  fortunately  situated,  being  the  capitol  city  and  so  the 
seat  of  the  State  Board  of  Health  laboratory.  Prompt  exami- 
nation of  specimens  for  tuberculosis,  diphtheria  and  the  like,  is 

76 


thus  secured,  as  is  the  possibility  for  prompt  administration  of 
anti-toxin. 

Records. 

The  records  of  the  sanitary  department  are  few  and  simple, 
as  corresponds  with  the  nature  of  its  ejideavors.  Too  much 
simplicity,  to  the  point  of  utter  neglect,  as  we  have  seen  in  the 
case  of  records  of  contagious  diseases  and  milk  inspection,  has 
characterized  them  in  the  past.  The  present  sanitary  sergeant 
has  taken  steps  to  improve  these  conditions  and  now  keeps  the 
following  permanent  books : 

Tuberculosis  cases 

Contagious  disease  cases 

Fumigations 

Vault  cleaning  permits 

The  records  now  kept  are  satisfactory^  to  the  work  m  hand, 
but  with  the  enlargements  in  the  service  advocated  in  this  re- 
port, considerable  enlargements  and  refinements  in  the  record 
keeping  system  will  be  necessary. 

Summary  of  Deficie^s^cies  in  the  City's  Health  Service. 

We  have  now  seen  that  the  city's  food  inspection  service 
misses  the  essentials  in  food  protection ;  that  the  city's  milk  in- 
spection does  not  in  any  way  adequately  meet  its  problem;  that 
its  communicable  disease  service  can  be  measurably  improved ; 
and  that  important  opportunities  in  infant  hygiene  and  tuber- 
culosis work  are  being  neglected.  Contributary  to  these  defi- 
ciencies and  principally  responsible  for  them  are  lack  of  funds 
and  a  full-time  health  officer.  The  bars  in  the  way  of  imm(>- 
diate  improvement  are  probably  inertia,  and  the  desire  to  keep 
expenses  at  a  minimum;  the  first  should  not  count  for  much 
in  a  progressive  Kansas  community,  while  the  second  is  surely 
false  economy.  Paint  for  a  house  is  a  Avise  investment,  because 
it  prevents  decay;  similarly  with  the  health  department  for  a 
community — the  protection  is  as  real,  and  the  relative  cost  as 
trifling. 

The  first  step  in  the  improvement  of  the  department 
should  be  the  appointment  of  a  full-time,  trained,  and  experi- 
enced health  officer.  With  the  great  advances  which  have  oc- 
curred in  sanitary  science  such  a  ]5erson  is  essential,  and  his 

77 


value  is  coming  more  and  more  to  general  recognition.  A  cit}' 
represents,  from  a  hygienic  standpoint,  a  great  complex  ma- 
chine, made  up  of  a  multitude  of  little  living  parts,  intricately 
interrelated.  Disease  always  exists  in  some  of  its  parts,  threat- 
ening both  to  spread  to  other  parts  and  to  decrease  the  effi- 
ciency of  the  whole  machine.  Modern  science  has  pointed  out 
the  nature  of  these  defects  and  the  ways  the  inefficiencies  may 
be  kept  to  a  minimum.  Surely  here  is  a  matter  calling  for  spe- 
cial knowledge.  In  industry  or  couimerce  no  one  would  think 
of  entrusting  the  supervision  of  such  a  complex  organization  to 
any  but  a  trained  sujDerintendent  or  manager.  Topeka,  m  fact, 
recognizes  this  principle  in  the  employment  of  an  expert  school 
superintendent,  at  a  salary  of  $4,500  a  year.  The  field  of 
public  health  is  certainly  as  wide  and  intricate  as  that  of  the 
schools;    and  calls  for  the  attention  of  a  man  of  equal  caliber. 

Recommendations  for  the  Improvement  of  the  City  Health 

Department. 

With  the  above  points  in  mind  Ave  may  recommend  Topeka 
a  modern  health  department  in  the  following  terms: 

1.  The  appointment  of  a  properly  qualified,  full-time 
health  officer.  His  appointment  should  be  for  a  term  of  years 
and  his  salary  should  compare  favorably  with  that  of  the  Su- 
perintendent of  Schools.  He  should  have  supervision  over  the 
milk  and  food  inspectors,  and  over  all  persons  and  work  here- 
after mentioned.  The  possibility  of  a  co-operation  arrange- 
ment with  Shawnee  county  for  the  employment  of  such  an  offi- 
cial is  suggested. 

2.  Radical  improvement  of  the  present  milk  inspection; 
including  revision  of  some  parts  of  the  existing  milk  ordinance, 
the  systematic  inspection  of  all  dairy  farms  and  milk-handling 
places,  and  the  introduction  of  the  bacteriological  examination 
of  milk.  The  inspector  should  be  supplied  with  proper  labora- 
tory and  transportation  facilities,  and  the  results  of  tests  should 
be  given  newspaer  publicity. 

3.  A  radical  reorganization  of  the  present  system  of  food 
inspection,  shifting  the  emphasis  from  the  reinspection  of  gov- 
ernment inspected  meats  to  the  inspection  of  markets  and  gro- 
ceries, and  of  small  local  slaughter  houses. 

4.  Extension  of  the  j^resent  work  against  communicable 

78 


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diseases  to  include  reinspectiou  of  quarantine,  the  visitation  of 
typhoid  fever  and  tuberculosis,  the  establishment  of  more  defi- 
nite periods  of  quarantine,  and  the  release  of  diphtheria  only 
after  cultural  diagnosis. 

5.  The  institution  of  a  comprehensive  campaign  against 
tuberculosis. 

6.  The  institution  of  work  against  infant  mortality. 

7.  The  institution  of  work  against  veneral  diseases,  in- 
cluding reporting  of  cases  to  the  health  department  (by  number 
if  so  desired),  and  the  provision  of  free  laboratory  diagnosis, 
and  of  free  treatment  in  indigent  cases. 

8.  The  institution  of  organized  Avork  for  health  educatic/U 
and  publicity. 

9.  Consideration  of  the  advisability  of  a  free  dispensary 
service  under  the  health  department ;  such  as  would  extend  and 
reinforce  the  department's  work  against  infant  mortality  and 
the  communicable  diseases,  including  tuberculosis  and  the  ve- 
nereal diseases. 

10.'  The  employment  of  two  or  more  ]:)ublic  health  nurses, 
to  be  utilized  in  the  inspection  of  quarantine  and  infant  hy- 
giene and  tuberculosis  Avork. 

A  reorganization  of  the  city's  public  health  Avork  along 
these  lines  is  indicated  graphically  in  the  diagram  on  page  TO. 


80 


IV.    SUMMARY  AND  CONCLUSIONS 

A^iTAL,  Statistics. 

Vie  have  now  seen  that  Topeka's  death  rate,  while  compar- 
ing favorably  with  that  of  the  coimtrv  as  a  whole,  shows  a  con- 
siderable excess  over  that  of  the  State  of  Kansas — and  this 
after  making  the  more  important  corrections.  At  the  same 
time  her  birth  rate  is  also  under  that  of  the  rest  of  the  state. 
Furthermore,  not  onh'  does  the  death  rate  show  marked  varia- 
tions in  the  several  wards,  but  similar  variations  are  found  in 
the  rates  from  the  various  preventable  causes  of  death.  The 
conclusion  is  justified  that  an  amoiuit  of  preventable  death  ex- 
ists in  the  cit}'  which,  while  not  alarming,  is  considerable,  and 
very  much  worth  fighting  against.  A  public  health  ]oroi3lem 
exists  which  -hovdd  yield  to  treatment. 

SaXITAR  Y    COXDITK  )XS. 

Survey  examinations  show  that  the  city  has  a  good  water 
supply:  but  that  it>  sewer  system  is  poorly  designed,  poorly 
constructed,  and  poorly  maintained.  Both  these  systems  iieed 
extending.  The  city's  milk  supply  is  in  a  markedly  unsatis- 
factory condition,  with  the  inspection  system  quite  inadequate: 
while  its  food  supply  is  in  general  good,  but  with  a  foolishly 
arranged  inspection.  Perhaps  one  of  the  most  serious  problems 
is  represented  by  the  presence  of  over  7.000  j^rivies  and  over 
5.000  wells.  Two-thirds  of  the  wells  examined  showed  evidence 
of  pollution,  and  many  of  them  are  unnecessary,  as  are  a  large 
number  of  the  privies.  Other  conditions  such  a  housing,  should 
receive  attention.  There  is  also  need  for  regular  and  system- 
atic physical  examination  of  school  children. 

The  City  Health  Department. 

The  organization  of  the  city  health  department  leaves 
much  to  be  desired.  Xot  only  are  its  food  and  milk  inspection 
services  pronouncedly  inadequate,  but  some  of  the  most  impor- 
tant opportunities  to  protect  the  public  health  are  neglected. 
The  number  of  persons  employed  and  the  amount  of  money  ap- 
jDropriated  are  both  too  small  for  a  reasonal)ly  complete  pro- 

81 


gram;  and  there  is  a  lack  of  centralized  and  properly  quali- 
fied authority.  The  latter  is  probably  the  most  serious  defect. 
A  full-time,  trained  health  officer,  to  be  supplied  with  more 
liberal  funds,  is  needed. 

CONCI.USIONS. 

TojDeka  has,  accordingly,  the  combination  of  a  considerable 
amount  (15  or  30  per  cent  of  the  total)  of  preventable  deaths 
and  a  number  of  objectionable  sanitar}^  conditions.  In  consid- 
ering a  practical  program  to  meet  the  situation,  consideration 
must  be  given  to  the  relative  importance  of  the  several  hygienic 
opportunities  with  regard  to  their  relative  cost.  On  this  basis 
the  city's  most  profitable  investment  will  probably  be  one  made 
in  its  health  department.  Important  repairs  and  extensions  of 
the  sewer  system  are,  for  example,  desirable,  and  undoubtedly 
would  show  good  results;  but  the  cost  of  such  work  is  rela- 
tively large,  and  a  perhaps  larger  and  more  immediate  saA^ng 
of  life  could  be  accomplished  by  the  expenditure  of  a  few  thou- 
sand dollars  for  a  few  public  health  mirses  and  an  expert  health 
officer.  The  larger  expenditures  for  comprehensive  sanitary 
improvements  are  not  to  be  deprecated;  they  certainly  should 
be  instituted ;  but  if  all  cannot  be  attempted  at  once  and  if  ex- 
pense be  a  limiting  factor,  it  should  be  remembered  that  the 
health  department  reorganization  will  probably  give  the  largest 
return  for  the  money  expended.  This  need  should  there- 
for be  given  precedence.  At  the  same  time  steps  should  be 
taken  to  solve  the  serious  well  and  priv}^  problem  by  a  policy 
of  restriction,  condemnation  and  publicity. 

The  public  health  situation  in  Topeka  is  one  of  good  nat- 
ural resources,  fair  development  of  material  sanitary  improve- 
ments, and  neglect  of  the  modern  methods  of  administrative 
control.  The  city's  organized  health  Avork  is  relati^^ely  primi- 
tive, there  being  here  a  rich  field  for  deA^elopment.  The  neces- 
sary expense  is,  fortunately,  not  great,  and  the  rewards,  as  ex- 
pressed in  increased  welfare  and  prosperity,  are  substantial  and 
considerable. 


82 


APPENDIX  "A". 

Part  of  a  report  on  Topeka  's  vital  statistics  prepared  by  Mr.  W.  J.  V. 
Deacon,  State  Eegistrar  of  Vital  Statistics.  Other  parts  of  tMs  report 
appear  in  the  text  of  the  Survey.  For  much  of  the  detailed  -n-ork  of  trans- 
cription and  tabulation  thanks  are  due  Miss  A>da  Hodgson,  Mr.  Herbert 
A.  Blinn,  and  Mr.  Morris  Sanders,  students  in  Washburn  College. 

Aisr  Intensfvt:  Study  of  Vital  Statistics  for  the  Topeka 
Improvement  Survey. 

Bv  W.  J.  Y.  Deacox,  state  Eegistrar  of  Vital  Statistics. 

Population  April  15,  1910    (U.  S.  Census),  43,684. 
Population  April  15,  1900   (U.  S.  Census),  33,608. 

Increase  30%  for  decade  or  3%  for  year. 
Correction   (Arithmetical  Method)  =  46,578,  population  July  1,  1912. 

Total  number  deaths  in  1912,  835. 

835 

=  17.9  per  thousand,  Crude  Death  Eate. 

46578 

jSiumber  of  deaths  of  non-residents,  171. 

835    —  171  =  664,  total  resident  deaths. 

=  14.2  per  thousand.     Corrected  death  rate  to  residents. 
White  population,  41,734,  deaths  553,  rate  13.2. 
Negro  population,     4,844,  deaths  111,  rate  22.9 


SPECIFIC  DEATH  BATES,  TOPEKA. 


AGE. 

No.  Deaths. 

Population. 

Death  Rate. 

134 
25 
49 
103 
155 
19S 

3.9S5 
7,162 
9,74S 
14,680 
8,202 
2.745 

33.6 
3.4     • 

5.1 

7.0 
17.6 
72.1 

5-14 

15-24 

25-44 

45-64 

TOPEKA  DEATH  RATE  COERECTED  TO  STATE  OF  KANSAS. 


AGE. 

Population. 

Specific  Death 
Rate,  Kansas. 

Calculated  No. 
of  Deaths. 

3.985 
7.162 
9,748 
14,680 
8,202 
2,745 

20.49 

1.74 

3.23 

5.15 

13.83 

63.81 

82 
12 
31 
76 
134 
175 

510 

5-14 

15-24 

25-44 

45-64 

65    and    over 

83 


510 


46578 


10.94,  standard  death  rate. 


10.16,  crude  death,  rate  of  Kansas, 


10.16 


10.94 


:=  .9287,  factor  of  correction. 


14.2,  crude  death  rate  Topeka,  X  .9287  =  13.19,  Corrected  to  Kansas. 


COEEECTED  DEATH  BATE  OF  TOPEKA  TO  STANDAED 
POPULATION  OF  SWEDEN. 


PojJula- 

No.  of 

Specific 

Standard  Age 

Index  of 

AGE. 

tion. 

Deaths. 

Death  Rate. 

Distribution. 

Mortality. 

0-1 

S15 

S5 

104.29 

25.5 

2.6 

1-19 

14,629 

94 

6.42 

39. S 

2.5 

20-39 

17,765 

110 

6.14 

269.6 

1.6 

40-59 

10,019 

121 

12.07 

192.3 

2.3 

60   and   over.  . 

3,350 

254 

75. S2 

114.6 

S.6 
17. S5 

COREEGTION  BY  AGE  AND  SEX  TO  UNITED  STATES  EEGIS- 
TEATION  AEEA. 


Total  calculated  deaths — Males,  381 
Females,  352 


733 


733 


46578 


18.05 


15.75,  standard  death  rate. 


18.05,  death  rate  for  registration  area. 


1.146,  factor  of  correction. 


15 .  75 

14.2,  crude  death  rate  X  1.146  =  16.27,  Corrected  rate. 

84 


POPULATION. 

SPECIFIC 
DEATH  RATE. 

CALCULATED 
DEATHS. 

Age. 

Male. 

Female. 

Male. 

Female. 

Male. 

Female. 

Under   5    

5-14 

15-24 

25-44 

45-64 

65    and    over 

2,775 
5.405 
4.S21 
6,403 
3,774 
1.169 

2,712 
5,313 
4.624 
5,736 
3,024 
S23 

56.26 
4.23 
6.51 
10.55 
25.02 
71.90 

47.39 

4.09 

6.06 

9.36 

21.09 

60.43 

156 
23 
31 

68 
95 

8 

129 
22 
28 
54 
64 
55 

CAUSES  OF  DEATH  AND  HATES  PER  100,000. 


Typhoid   Fever    

Small    Pox    

Scarlet   Fever    

Whooping  Cough  .... 

Diphtheria 

Dysentery 

Tuberculosis     (all 
forms) 

Cancer    (all    forms... 

Rheumatism    (all 
forms) 

Diabetes 

Other  general   dis- 
eases  

Meningitis 

Cerebral    Hemorrhage 

Paralysis 

Other    diseases    of 
nervous   system    .  .  . 

Organic    Heart    Dis- 
ease  

Other    diseases    of 
circulatory    system . 

Broncho-pneumonia    . 

Pneumonia 

Other   diseases  of 
respiratory   system. 


No. 

[ 

Deaths. 

Rate. 

9 

19.3 

1 

1 

2.2 

" 

4.3 

16 

34.8 

3 

6.5 

47 

102.2 

40 

S7.0 

5 

lO.S 

9 

19.3 

13 

28.3 

5 

10.8 

31 

67.4 

IS 

39.2 

22 

47.8 

59 

128.2 

31 

67.4 

23 

50.0 

34 

73.8 

12 

26.1 

Diarrhoea  and  Enter- 
itis,  under   2  years. 

Diarrhoea  and   Enter- 
itis,   over    2    years.  . 

Appendicitis 

Diseases   of   Liver 
and   Adnexa    

Peritonitis 

Other  diseases   of   Di- 
gestive system    .... 

Acute   Nephritis 

Bright's    Disease    .  .  .  . 

Other   diseases,   Gen- 
ito-Urinary   system. 

Puerperal   state    

Diseases   of  skin.    etc. 

Diseases   of   bones, 
etc 

Malformations 

Diseases   of   early 
infancy  

Old  age  

Suicides 

Accidents 

Homicides 

Ill-defined  diseases    .  . 


No. 

Deaths. 

Rate. 

25 

54.4 

Y 

16.2 

' 

16.2 

7 

16.2 

4 

S.7 

14 

30.5 

5 

10.8 

54 

117.3 

5 

10.8 

10 

21.7 

2 

4.3 

1 

9  ■■> 

5 

10.8 

35 

76.2 

36 

78.4 

9 

19.3 

26 

56.5 

7 

16.2 

19 

41.3 

APPENDIX  ''B". 
Ward  Vital  Statistics. 

(Residents  alone  are  considered.) 
BIRTH  AND  DEATH  RATES  PER  l.OCO. 


Birth* 

Infant  Death  Rate 

Death 

Birth* 
Rates 

Birth* 
Rates 

Rates 
Avg. 

Rates  of 
Increase 

per  1,000 

Birthsf 

Wards. 

1912 

1912 

1913 

1912-13 

1912 

1912 

1910-13 

I.  ..  . 

16.2 

18.8 

17.5 

18.2 

2.6 

108 

98 

II.  .  .  . 

16.1 

21.0 

20.3 

20.7 

4.9 

108 

97 

Ill 

19.1 

10.7 

11.7 

11.2 

—  8.4 

66 

46 

IV 

12.0 

17.8 

14.9 

16.4 

5.8 

38 

66 

V 

7.6 

26.4 

19.1 

22.8 

IS. 8 

100 

84 

VI 

11.6 

.    18.5 

18.3 

18.4 

7.1 

161 

71 

Totals. 

14.2 

19.8 

17.4 

18.6 

5.6 

96 

74 

*Excluding   hospital    births   except    in    totals, 
f Registration   incomplete. 


85 


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Diarrhoea  and 

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per  1,000  Births. 

1912-1913 

51.1 

56.0 
25. S 
20.7 
5.7 
61.3 

35.9 

M 

«"cn 

t-  .22  (31 
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92.6 
115.6 
28.9 
33.7 
13.0 
112.8 

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21.9 
30.7 
6.2 
21.2 
13.8 
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233.8 
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189.8 
280.6 

193.6 

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143.4 
154.3 
65.6 
90.4 
107.0 
134.0 

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90.4 
59.4 
63.6 
61.3 
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146.6 

76.0 

tegistration    ii 

V 
3 

I.  .  .  . 

II 

III.  .  .  . 
IV 

V.  .  .  . 
VI 

City 

86 


DEATH  BATES  FEOM  CEETAIN  COMMUNICABLE  DISEASES 
OF  CHILDEEN,  PEE  100,000. 


Whooping 

Diphtheria* 

Scarlet  Fever* 

Measles* 

Cough* 

Total* 

Wards. 

1908-13 

1908-13 

1908-13 

1908-13 

1908-13 

I 

38.3 

0 

8.2 

13.7 

60.2 

II 

38.2 

0 

5.7 

7.1 

51.0 

Ill 

10.3 

4.1 

0 

4.1 

18.5 

IV 

0 

0 

0 

2.3 

2.3 

V 

4.6 

0 

4.6 

6.9 

16.1 

VI 

11.9 

0 

4.0 

7.9 

23.8 

City.... 

19.1 

0.8 

3.7 

6.7 

30.3 

*Registration  incomplete. 


NET  DENSITY  OF  POPULATION,  TOPEKA  WAEDS,  1910. 
(Persons  per  acre  of  platted  area.) 


Ward  I. 
Ward  II. 
Ward    III. 


City 


13. S 
24.5 
24.2 


Ward  IV. 
Ward  V. 
Ward    VI. 


21.8 

12.7 

8.9 


APPENDIX  '^C". 


Analysis  of  Topeka  City  Water,  Oct.  15,  1913. 

By  State  Water  Survey. 


Laboratory    No 

6148-24 
C.   S. 
J.   Shaw 
10-15-13 
10-20-13 

MINERAL   ANALYSIS. 

Source 

Collected   by    

Date    of    Collection 

Analysis    Completed    

CL 

SO4 

HCO3 

143. 

6.58 
256. 

CHEMICAL,  ANALYSIS. 
Results  in  parts  per  million. 

BACTERIAL    EXAMINATION. 

Color 

Odor 

Turbidity 

Oxygen    consumed    

Nitrogen   as   Free  Ammonia 
Nitrogen   as   Alb.    Ammonia 

Nitrogen   as   Nitrites 

Nitrogen   as   Nitrates 

Solids   Total    

Soap    Titration     (CaCo) 

None 
None 
None 

1.5 
.102 
.082 

0.0 

0.0 
619. 
250. 

Bacteria    per    cc.    on   Agar, 
at  37°     24  hrs 

16 
Negative 

1— 

5— 

5— 

Presumptive    Tests    for    B. 

coli 

No.   of  Positive  Fermenta- 
tions: 

In  one  10  cc.   tube 

In  five  1   cc.  tubes 

In   five   .1   cc.   tubes.... 

87 


APPENDIX  "D". 

FIELD   NOTES   OF   PBOF.   G.   E.   JONES'   INVESTIGATION   OF 

TOPEKA  SEWEES. 

Inspection    of    City    Park    Outfall    and    Branches. 

November     17.     1913. 

1.  Beginning  at  tlie  river  bank,  a  six-by-five-foot,  egg-sliaped  combined 
sewer.  Material  of  which  constructed,  soft  brick  laid  in  lime  mortar.  The 
flow  at  the  outfall  is  about  one  foot  in  depth,  and  the  velocity  is  very  high. 
This  sewer  has  been  in  use  something'  like  twenty-five  years.  The  invert  is 
badly  worn;  advancing  into  the  sewer,  a  wide  crack  was  found  in  the  top. 
This  crack  was  an  inch  and  a  half  wide  and  extended  for  two  hundred  feet 
back  from  the  entrance.  Also,  at  the  springing  line,  many  bricks  were 
missing. 

2.  One  hundred  feet  south  of  the  outfall,  a  three-foot  v^  C  P,  enters. 
This  branch  h?s  six  inches  of  flow  in  it.  Two  hundred  feet  from  the  outfall. 
a  larg-e  closet  in  the  City  Park,  is  connected  with  the  sewer  by  means  of  two 
IS-inch  V.  C.  P.  These  pipes  enter  the  main  sewer  at  an  angle  of  sixty 
deg'rees  with  the  vertical.  The  connection  is  poorly  made,  no  care  having 
been    taken    to    replace    loosened    bricks    or    to    cement    around    the    pipes 

3.  In  manv  olaoes.  the  walls  of  the  sewer  were  wet,  due  to  ground 
water  seeping  into  the  sewer.  Three  hundred  feet  from  the  outfall,  two  catch- 
basins  drain  into  the  sewer  by  means  of  S-inch  pipes.  These  catch-basins  were 
in    filthy    condition. 

4.  From  this  point  on,  properly  designed  V.  C.  P.  inlets  for  house  con- 
nections were  found  in  the  walls  of  the  sewer.  These  inlets  occurred  every 
twenty-five  feet,  but  in  the  ma.iority  of  the  connections,  no  use  has  been  made 
of  them.  It  seemed  to  have  been  the  practice,  in  makin.g  house  connections, 
to  enter  the  main  sewer  in  the  most  convenient  manner,  no  attention  being 
given  to  replacing  loosened  brick,  or  making  the  sewer  tight  around  con- 
nections. 

5.  At  Van  Buren  and  Crane  Sts..  the  nnanhnle  cover  was  buried  under 
the  street.  Inspected  from  below.  The  brick  was  in  good  condition.  The 
manhole    was    circular    and    of    good    design. 

6.  One  hundred  feet  south  of  the  intersection  of  Van  Buren  and  Crane 
Sts.,    a    place    was    found    where    the    invert    was    badly    worn. 

7.  Manhole  at  First  and  Van  Buren  Sts.  The  cover  is  under  the  street. 
Inspected  from  below.  The  masonry  was  in  good  condition  and  clean.  No 
perceptible    odor   was    noticed. 

8.  The  sewer  here  turns  west  on  First  Street.  At  the  alley  between 
Van  Buren  and  Harrison,  a  15-inch  V.  C.  P.  enters  from  the  south.  Manhole 
on  alley  between  Harrison  and  Topeka  Avenue  in  good  condition.  The  Harrison 
Street    sewer    enters    four    feet    above    the    invert    of    the    main    sewer. 

9.  Manhole  at  Topeka  Avenue  and  First  Street,  12-inch  pipe  enters  in 
good    condition. 

10.  Manhole  at  Tyler  and  First  is  circular  brick,  12  feet  deep.  No 
connections  enter  here.  There  is  considerable  ground  water  at  this  point.  The 
sewer  here  turns  south.  House  connections  occur  every  twenty-five  feet,  but 
many    are    unused. 

11.  Manhole  one  hundred  feet  south  of  First  and  Tyler  Sts.  Brick  in 
fair  condition;  three  inches  of  flow  in  sewer;  current  very  rapid.  The  sewer 
turns  west  up  and  east-and-west  alley.  Three  inches  of  flow.  Sewage  is  hot 
and    considerable    steam    is    present. 

13.  On  Second  Street,  between  Polk  and  Tyler,  a  creamery  discharges 
into  the  sewer  a  large  quantity  of  boiling  hot  water,  and  fills  the  sewer  with 
steam.. 


14.  Line  turns  west  on  Second  Street.  At  Polk  Street,  there  are  two 
inlet  catchrbaslns  on  each  side  of  the  street.  These  are  in  good  condition. 
Line  turns  south  on  Polk  Street.  Steam  and  considerable  odor  issues  from 
the    manhole    and    inlets    at    Second    and    Polk. 

15.  Sewer  reduces  to  a  50  x  66-inch  at  Second  Street  and  Polk.  At  Third 
and    Polk    Sts.,    there    are    four    curb    inlets    draining    into    sewer. 

16.  Manhole  at  Fourth  and  Polk  Sts..  14  feet  deep.  The  bottom  in  bad 
condition.      Three    street    inlets    enter    here. 

17.  Manhole  at  Fifth  and  Polk  Sts.,  13.2  feet  deep.  Three  street  inlets 
enter  at  this  point.  Sewer  branches  at  this  point,  a  24  x  36-inch  egg-shaped 
brick  sewer  going  south,  and  the  main  sewer — a  4S-ineh  egg-shaped — turns 
west.  Did  not  pass  through  th.ese  sewers.  Remainder  of  inspection  on  this 
systenn  -was  from  manholes.  Following  the  48-inch  on  west,  there  is  a  crack 
in    the   top   running   west    on    Polk,    evidently    due   to    the    settlement. 

IS.  Manhole  at  Fifth  Street.  A  16-inch  pipe  enters  from  the  west,  a 
12-inch  from  the  north.  This  manhole  is  built  to  one  side  of  the  main  sewer, 
and  there  is  no  manhole  in  the  main  sewer.  There  is  an  inlet  on  both  sides 
of    the    street.      The    main    sewer    turns    south    and    follows    Western    Avenue. 

19.  Manhole  between  Fifth  and  Sixth  on  Western  Avenue.  Size  of  main 
sewer,  42  Inches.  10-inch  laterals  enter  from  the  east  and  west.  4  inches  of 
flow  in  the  main  sewer,  with  a  good  velocity.  Two  street  Inlets  at  Sixth  and 
Western    enter    the    sewer. 

20.  Manhole  on  Western  between  Sixth  and  Seventh.  One  10-inch  lateral 
from  the  east  and  one  from  the  west  enter  here.  The  size  of  the  main 
sewer    is    42    inches. 

21.  Manhole  at  Seventh  and  Western  Avenue.  There  are  four  inlets  that 
enter  sewer  at  this  point,  also  a  15-lnch  pipe  from  the  east.  The  main  is  a 
42-inch    on    the    lower    side,    reducing    to    a    34  x  26    on    the    upper. 

22.  Manhole  on  Seventh,  150  feet  west  of  "Western  Avenue.  Three  inches 
of  flow  at  a  good  rate.  A  24 -inch  pipe  enters  from  the  west,  an  IS-inch  pipe 
from    the    south.      This    is    the    end    of    the    brick    sewer    on    this    branch. 

23.  Going  back  to  the  manhole  on  Fifth  and  Polk,  where  the  main  line 
branches,  and  followin.%'  the  36  x  27-inch  line  that  goes  south  on  Polk  Street 
at    this    point. 

Manhole  inlet  built  in  curb  at  Sixth  and  "Western  Avenues.  No  laterals 
enter  at  this  manhole.  The  manhole  is  in  bad  condition.  Design  and  con- 
struction   are    very    poor.       Impossible    for    one    to    enter. 

24.  Manhole  150  feet  Avest  of  Sixth'  and  Western  Avenues.  Size  of  main 
27  X  36-inch,     egg-shaped    brick. 

25.  Manhole  on  Tyler  and  Sixth  Street.  This  is  the  end  of  the  brick 
sewer.      A    24-inch    X.  C.  P.    comes    in    from    the    south.       Rapid    rate    of    flow. 

26.  Following  south  on  the  24-inch  pipe,  manhole  100  feet  south  of  Sixth 
on  Tyler  Street.  A  24-inch  pipe,  an  8-inch  lateral  coming  in  from  the  east. 
Two  and  one-half  inches  of  flow  at  a  slow  rate.  No  manhole  on  Seventh. 
There    are    two    inlets    at    Seventh    and    Tyler. 

27.  Manhole  100  feet  north  of  Eighth  and  Tyler.  Two  S-inch  laterals 
enter,    one    from    the    east    and    one    from    the    west.      Slow    rate.       2-inch    flow. 

28.  Manhole  between  Eighfn  and  Ninth  on  Tyler.  Depth,  12  feet.  A 
12-inch  pipe  enters  from  the  south,  a  15-inch  from  the  west,  and  a  9-inch 
from  the  east.  This  manhole  is  in  bad  condition.  The  seepage  from  the 
ground  water  is  bad,  and  the  mortar  is  falling  from  between  the  bricks. 
There    is    a     good    rate    of    flow     in     the     line     from    the    west. 

29.  Following  the  12-inch  line  on  the  south.  Manhole  on  Tyler  and 
Ninth.       Fair    rate    of    flow.       One    inch    in    depth 

30.  Manhole  at  Tenth  and  Tyler  was  not  opened.  Inlet  manhole  on  alley 
200  feet  north  of  Eleventh,  between  Tyler  and  Topeka.  Little  flow  and 
slow     rate. 

31.  Manhole     on     alley     at     Eleventh     was     not     opened. 

89 


32.  Manhole  on  alley  between  Topeka  and  Tyler  at  Twelfth.  No  flow 
here,  as  it  is  the  end  of  the  line.  The  grade  falls  away  to  both  the  north 
and    south. 

33.  Beginning  at  manhole  on  Seventh  Street,  150  feet  west  of  Western 
Avenue,  at  the  end  of  the  brick  sewer,  and  following  the  line  south  on  the 
18-inch    pipe: 

Manhole  100  feet  north  of  Eighth  was  not  opened,  but  a  bad  odor  was 
noticeable    at    a    considerable    distance. 

34.  Manhole  100  feet  south  of  Eighth  was  not  opened.  Some  odor 
noticeable    here. 

35.  Manhole  on  alley  100  feet  north  of  Tenth.  Bad  odor  and  slow  rate 
of  flow.  Depth  of  flow,  3  inches.  The  main  is  a  15-inch  pipe.  No  laterals 
enter   here.      Four   inches    of   sludge    in    the    bottom   in    a    septic    condition. 

36.  Manhole  100  feet  south  of  Tentli  was  not  opened.  Noticeable  odor. 
Sewer    turns    east    here. 

37.  Manhole  on  Western  100  feet  south  of  Tenth.  One  inch  of  flow. 
Septic  action  noticeable,  and  a  bad  odor.  12-inch  main  and  a  12-inch  lateral 
from  the  north.  The  line  crosses  Western  Avenue,  goes  through  to  the  alley 
east  and  turns  south.  There  is  supposed  to  be  a  manhole  at  this  point,  but 
unable  to  find  it,  nor  the  one  on  Eleventh.  Evidently,  both  are  under  the 
pavement. 

38.  Manhole  at  Twelfth  and  Western  Avenue..  A  12-inch  main.  Two 
inlets    from    the    street.      I^ine    turns    west. 

39.  Manhole  at  alley  on  Twelfth,  150  feet  west  of  Western;  a  12-inch 
main  sewer,  benches  flat,  and  septic  action  in  evidence.  Fair  rate  of  flow. 
Surface  drainage  from  the  street  enters  the  manhole  through  the  grating.  The 
result    is    that    the    manhole    is    in    a    filthy    condition. 

40.  Manhole  at  alley  on  Huntoon,  between  Western  and  Fillmore.  A 
12-inch  main,  a  9-inch  pipe  from  the  southeast,  an  8-inch  from  the  south.  The 
pipe  from  jthe  south  is  filled  with  dirt,  little  or  no  flow.  We  were  able  to  see 
through  to  the  next  manhole  by  means  of  a  lantern,  so  the  alignment  is 
good. 

41.  Beginning  at  the  manhole  on  the  alley  at  Seventh,  150  feet  west  of 
Fillmore,  and  going  south;  septic  action  is  evident.  An  18-inch  V.  C.  P.  enters 
from  the  south.  A  21-Inch  east  and  west  main.  A  light  could  be  seen 
for  two  blocks  south  through  an  18-inch  V.  C.  P.  The  alignment  is  good,  rate 
of   flow   good;    septic   action   due    to   deposits   on   the   benches. 

42.  Manhole    100    feet    north    of    Eighth    Street    was   not    opened.      Some    odor. 

43.  Manhole  inlet  at  100  feet  south  of  Eighth.  Bad  odor,  septic  action, 
slow  rate  of  flow.  An  18-inch  main  with  9-inch  pipes  entering  from  the  east 
and    west.      One    inch    of    flow.      Sewage    rather    heavy. 

44.  Manhole    on    ninth    was   not    opened. 

45.  Manhole  on  Tenth.  12-inch  main  flowing  in,  and  &  15-inch  flowing 
out.  Some  odor.  Car  tracks  interfere  with  the  entrance  to  the  manhole.  The 
rate    of    flow    was    very    slow. 

4  6.     No    manhole    found    on    either    Eleventh    or    King    Streets. 

47.  Manhole  150  feet  south  of  King  Street.  A  12-inch  main.  No  laterals 
enter  here.  Small  depth  of  flow,  but  good  rate.  Very  little  odor.  It  was 
possible    to    see   a   light    through    for    one    and    a   half   blocks. 

48.  Manhole  at  Huntoon.  A  12-inch  pipe  out.  This  is  a  dead  end.  A 
6-inch    pipe    from    the    southwest.      No    odor.      Little    or    no    flow. 

4  9.  The  36-inch  Brick  Sewer  at  City  Park  outfall  going  south  past  the 
State  House.  This  sewer  flows  into  the  72  x  54-inch  sewer  200  feet  from  its 
outfall. 

Manhole  in  City  Park.  The  cover  is  IS  inches  under  the  surface  of  the 
ground.       Eight    inches    of    flow.       Rapid    rate    of    flow. 

50.  Catch-basin  100  feet  south  is  filled  up.  Catch-basin  stopped  up  at  Rock 
Island    right-of-way. 

51.  Manhole  on  Second  Street,  north  side  of  the  street.  No  laterals.  A 
36-inch  brick  sewer  with  seven  inches  of  flow.     Good  rate  and  good   conditions. 

90 


52.  Manhole  on  Third  Street.  Two  connections,  each  an  8-inch  pipe,  enter 
here.  Depth  of  flow  5  inches.  Bottom  in  good  condition.  36-inch  sewer  with 
high   velocity.      Alignment    is    good. 

53.  Manhole    halfway   between    Third    and    Fourth.      Casting    is    broken. 

54.  Manhole  north  side  of  Fifth  Street,  a  12-inch  lateral  from  the  southwest 
and  a  12-inch  lateral  from  the  southeast  entering  the  above-mentioned  main. 
The  masonry  is  in  good  condition.  Depth  of  flow  is  4  inches.  Good  align- 
ment and  high  velocity. 

55.  Open  inlet  halfway  between  Fifth  and  Sixth  Streets.  10-inch  laterals 
from   the   southeast    and    the    southwest. 

56.  Manhole  on  Sixth.  S-inch  V.  C.  P.  from  the  west.  Main  sewer  24  x  36 
inches. 

57.  Manhole  on  alley  between  Sixth  and  Seventh:  brickwork  in  bad  shape. 
Six  inches  of  flow,    15-inch   pipe  from  the  west   and  a  12-inch  from  east. 

58.  Manhole  at  Seventh  Street.  24-inch  main.  Two  12-inch  V.  C.  P.  One 
from  southeast   and   one   from   the  southwest. 

59.  Manhole  between  Seventh  and  Eighth  Streets,  at  alley.  Depth  11.6 
feet.  Ladder  brokeen  and  two  4-inch  and  a  10-inch  heating  pipe  passing  through 
the    manhole    and    obstructing    same. 

60.  No  manhole  found  on  Eighth  Street.  The  sewer  angles  off  to  the  south- 
east here,    100    feet   south   of   intersection   of  Jackson    and   Eighth. 

61.  Manhole  150  feet  east  of  Jackson  Street.  11.5  feet  deep.  One  and  a 
half  inches   of   flow.      Masonry   in   good   condition.      Sewer   turns   south    on   alley. 

62.  Manhole  at  alley  on  Ninth  Street.  One  and  one-half  inches  of  flow.  A 
12-inch   v.  C.  P.    main,    9-inch    branch.      In    good    condition, 

63.  Manhole  200  feet  south  at  bend  in  alley.  A  12-inch  V.  C  .P.  main.  12.9 
feet  deep.     Very  little  flow. 

64.  Manhole  75  feet  north  of  Tenth.  A  9-inch  V.  C.  P.  main.  Is  12.4  feet 
deep.     Also   has   very   little   flow.      Manhole   very   small.      Hard   to   enter. 

65.  Starting  at  alley  on  Fifth  Street,  between  Jackson  and  Van  Buren,  going 
west   from   the    36-inch    sewer   along   the    15-inch   V.  C.  P. 

66.  No   manhole   found   at   Van  Buren    and   Fifth.      Three    street   inlets. 

67.  Manhole    south    of    Court    House    had    a    4-inch    flow.      Conditions    good. 

68.  Manhole  on  alley  west  of  Harrison  and  Fifth.  Sts.,  covered  by  pave- 
ment.     Sewer    turns   south    here. 

69.  Manhole  in  alley  200  feet  south  of  Fifth  Street.  Practically  no  flow. 
18-inch  V.  C.  P.  enters,  and  a  15-inch  pipe  going  out.  Six  inches  of  flow  and 
three  inches  of  sediment  in  the  bottom,  showing  either  an  obstruction  or  else 
too  flat  a  grade.     The  manhole   construction   is   good. 

70.  No   manhole    found   on    Sixth    and    Seventh    Sts. 

71.  Manhole  200  feet  south  of  Seventh.  A  12-inch  main.  Rate  of  flow 
very    slow.      Two    and    one-half    inches    of   flow. 

72.  Manhole  100  feet  south  of  Eighth  Street.  2-inch  flow,  12-inch  main, 
very  slow  rate   of  flow. 

73.  No  manhole  found   on  Ninth  or  Tenth   Sts. 

74.  Manhole  at  100  feet  south  of  Tenth.  A  12-inch  V.  C.  P.  main.  Sewer 
turns  east  here.      Also   a  branch   going   south. 

75.  Larnphole,  dead  end  at  Eleventh  on  alley  between  Harrison  and  Van 
Buren. 

Jackson  Street  Main,. 

76.  Beginning  at   Sixth   and  Jackson   Sts.     No  manhole.      Three   curb   inlets. 

77.  Manhole  at  Fifth  and  Jackson  Sts.,  has  been  covered  by  the  asphalt 
pavement. 

78.  No    manhole    at    Fourth    and    Jackson    Sts.      Two   street    inlets    here. 

79.  Manhole  at  Third  and  Jackson.  8-inch  V.  C.  P.  enters,  and  a  12-inch 
leaves.  Three  inches  of  even  flow.  Manhole  in  fair  condition.  Two  inlets  here. 
Grade   is    less    going   out    than    coming    in. 

80.  Manhole   cover   at   Second   and   Jackson   Sts.   cemented   shut. 

81.  Manhole  100  feet  south  of  Rock  Island  tracks.  Lateral  coming  in  from 
the  east.     Main  is  15  inches  V.  C.  P.     One  inlet  and  one   catch-basin   here. 

91 


52.  Open  drain  on  east  and  west  sides  of  Jackson  Street  from  First  to  Park. 
This    drain     is    2x3    feet    and    carries    storm    water    onl5'. 

53.  Manhole  at  Jackson  and  Crane  Sts.  A  21-inch  V.-C.  P.  main.  A  10- 
inch  lateral  enters  from  the  east.  Rapid  rate  of  flow.  Four  inches  of  flow. 
S.5  feet  deep.  There  is  bi  fiO-inch  brick  storm  sewer  built  from  here  to  the  river. 
This  connects  with  the  two  open  drains  that  run  down  the  sides  of  Jackson 
Street.      The    .Tackson    Street    sewer    empties    into    the    36-inch    brick    sewer. 

Inspection  of  North  Topeka  Sewer. 

November    22,    1913. 

1.  Inlet-manhole  at  alley  west  of  Kansas  Avenue  on  Klous  Avenue.  The 
sewage  here   is   in   bad   condition,    giving   off  bad   odor. 

2.  Manhole  at  alley  west  of  Kansas  Avenue  on  Kistler  Avenue.  The  sewage 
has   a   fair   velocity. 

3.  Manhole  100  feet  east  of  Central  Avenue  has  considerable  sludge  in  the 
bottom.      The   odor   is   bad. 

4.  Manhole  at  Park  and  Central.  Sewer  is  in  good  condition  and  the  flow 
is   good. 

5.  Manhole  on  Gordon  Avenue  one  half  block  west  of  Jackson  Street.  This 
manhole   was    not    entered,    but    the    odor    was    very    noticeable. 

6.  Manhole  on  Park  Avenue,  one-half  block  west  of  Central.  There  is  13 
inches  of  flow  and  a  very  slow  rate.  A  42  x  2S-inch  sewer  flows  east,  and  a 
24-inch  V.  C.  P.  comes  in  from  the  west.  There  is  a  12-inch  V.  C.  P.  from  the 
north,    and   a   10-inch   V.  C.  P.    from    the   south,    both    being   submerged. 

7.  Manhole  on  Fairchild  Avenue,  one-half  block  east  of  Qulncy.  There  is 
a  bad  odor  here.  12-inch  V.  C.  P.  enters  from  the  south,  also  a  15-inch  enters 
from  the  south.  The  manhole  was  full  of  mosquitoes  which  is  good  evidence 
of   stagnant   watei\      The   46  x  30-inch   sewer   goes   east,    with   six   inches   of   flow. 

8.  At  Falrchilds  and  Monroe  there  are  four  curb  inlets  that  need  cleaning 
badly.      There   is  no   manhole   at   this   corner. 

9.  Manhole  on  Fairchild  one-half  block  east  of  Monroe.  A  12-inch  V.  C.  P. 
enters  from  the  north.  A  12-inch  V.  C.  P.  enters  from  the  south  The  flow  is 
very   rapid. 

10.  Manhole  on  Fairchild  Street  one-half  block  east  of  Madison.  A  12-inch 
V.  C.  P.  enters  from  the  north.  A  12-inch  V.  C.  P.  enters  from  the  south.  The 
size  of  the  main  sewer  is  34  x  54  inches.  There  are  nine  inches  of  flow  in  the 
main.     The  rate  is  very  slovsr,   and  the  odor  is  very  bad. 

11.  Inlet  manhole  on  Fairchild  50  feet  east  of  Santa  Fe  and  Rock  Island 
tracks.  The  flow  is  rapid.  It  is  9.8  feet  to  water  line.  There  is  considerable 
sludge    in    the    bottom,    and    the    odor    is    bad. 

12.  Outlet   into   the   Kansas   River. 

The  outfall  of  this  line  is  100  feet  west  of  the  present  stream  channel. 
There  is  a  flood  gate  four  feet  in  from  the  outfall.  There  is  nine  inches  of  flow, 
and   considerable    mud   in   the   bottona    of   the   sewer. 

At  this  point  is  located  the  only  sewage  pumiJing  station  in  the  city.  This 
pumping  station  is  on  the  land  side  of  the  concrete  dike,  and  is  used  to  pump 
the   sewage   when   the   water   surface  is   above   the   outfall. 

Inspecticn  of  Places  Reported  as  Being  in  Bad  Condition.. 

1.  Eleventh  and  Lane  Streets.  The  catch-basins  here  are  in  bad  condition, 
and  there  is  a   bad   odor  coming  from   the   same. 

2.  Manhole  north  of  Eleventh  Street  on  Lane  Street.  The  benches  are 
flat  and  covered  with  refuse.  The  main  sewer  is  a  24-inch  V.  C.  P..  the  depth 
of  flow  is  one  inch.  An  S-inch  tile  pipe  enters  from  the  west.  The  odor  here 
is  extremely   bad. 

3.  Alley  between  Lincoln  and  Lane  Sts..  between  Tenth  and  Eleventh  Sts. 
The  main  is  21-inch  V.  C.  P.  with  a  one-inch  flow.  A  6-inch  V.  C.  P.  enters  from 
the  east  two  feet  above  the  invert  of  the  main  sewer  The  benches  in  this 
manhole  are  flat  and  covered  with  deposit.  The  sewage  is  quite  heavy,  and  the 
odor  is  bad.  , 

92 


4.  Manhole  at  alley  west  of  Lincoln  and  on  the  north  side  of  Eleventh  Street. 
There  is  an  IS-inch  V.  C.  P.  from  the  east,  and  a  21-inch  going  north,  and  a 
15-inch  V.  C.  P.  from  the  south.  There  is  one-half  inch  of- flow,  and  considerable 
mud  in  the  bottom.  There  is  a  bad  odor  here,  and  iDiactically  no  flow  from 
the  south.  This  may  be  accounted  for  by  the  flush  tank  further  south  being  out 
of  working  order.  This  flush  tank  is  on  the  nortli  side  of  Huntoon,  between 
Lincoln   and   Lane    Sts. 

5.  Manhole  on  alley  north  of  Sixth  end  west  of  Western  Avenue.  The  man- 
hole  is  in   bad   repair,    the   allej''   is   in   filthy   condition,    and   the   sewage   is   septic. 

6.  Manhole  on  alley  nortli  of  Sixtli  and  west  of  Home  Street.  Sewage 
is    in    fairly    good    condition,    but    the    velocity    small. 

V".  This  line  was  followed  to  Willow  Park  and  north  on  an  alley  to  Park 
Avenue,  and  a  little  way  beyond.  A  lateral  was  then  picked  up  on  the  Drive, 
and  followed  up  on  Hawthorne  to  where  it  joins  in  on  the  12-inch  from  the 
Circle  Street,  and  then  continues  to  the  15-inch  iron  pipe  across  the  creek,  and 
thence  to  the  river.  In  time  of  heavy  rains,  the  water  backs  up  and  throws 
the  manhole  covers  on  this  line.  The  outlet  at  the  Kansas  River  was  not  under 
water,  as  shown  by  an  old  blue-print;  Viut  was  well  above  the  water  line.  In 
nearly   every   manhole   on    this   line,    the   flow   was    very   slow. 

8.  Inlet-manhole  at  Morris  and  Eighth  Sts.  A  24-inch  V.  C.  P.  enters  from 
the  south  and  a  36  x  22-inch  goes  on  to  the  north.  A  12-inch  V.  C.  P.  enters 
from  the  east,  with  a  good  flow.  There  is  three  inches  of  flow  in  the  24 -inch  and 
in   the    36-inch    sewers,    and   the   alignment    is    good. 

9.  Inlet-manhole  between  Seventh  and  Sixth  in  the  alley,  and  xvest  of 
Morris  in  the  log.  The  36-inch  turns  and  goes  east  here  for  half  a  block.  The 
alignment  is  O.  K.  A  12-inch  V.  C.  P.  enters  from  the  north.  There  is  two 
inches  of  flow,  and  four  inches  of  mud  in  the  36-inch  sewer.  The  depth  to  the 
water   line    is    6.4    feet.      The    masonry    is    in    good   condition. 

10.  Manhole  at  Morris  and  Sixth  Sts.  At  this  manhole  a  36  x  22-inch  brick 
enters  from  the  south,  and  a  30-inch  V.  C.  P.  enters  from  the  east,  while  all  of 
this  flow  is  carried  away  by  a  15-inch  V.  C.  P.  to  the  north.  The  sewage  was 
backed   up   into   the   manhole   above   the   top   of   the   15-inch   pipe. 

11.  Inlet-manhole  at  Fifth  and  Morris  Sts.  The  15-inch  pipe  enters  and 
leaves  this  manhole.  The  flow  stands  above  the  benches,  and  with  storm  water 
must   rise   much    higher. 

12.  Manhole  at  Elmwood  and  Willow  Park.  Here  the  15-inch  line  picks  up 
a  10-inch  line  from  the  east.  The  flow  is  very  rapid,  and  the  depth  of  flow  is 
four   inches. 

13.  Inlet-manhole  at  Cherokee  and  alley  west  of  Elmwood  Sts.  The  15-inch 
turns  here  and  goes  north  on  the  alley.  Velocity  is  high,  with  four  inches  of 
flow. 

14.  Manhole  at  Park  Street  and  alley  west  of  Elmwood  Street.  This  is  the 
same   15-inch   main.      Velocity    is   high  with   six   inches   of  flow. 

15.  Manhole  at  Park  Street  and  the  Drive.  The  15-inch  pipe  turns  here 
and   goes   in    a  northwest   direction   on    the   Drive.      Flow    is   very   fast. 

16.  Manhole  at  Laurel  and  Knox  Sts.  The  15-inch  line  goes  through  here, 
the  velocity  is  good,  and  the  flow  is  four  inches.  A  10-inch  V.  C.  P.  enters  from 
the  east. 

17.  Manhole  250  feet  east  of  the  junction  of  Hawthorne  and  the  Circle. 
The  15-inch  line  enters  from  the  south  three-fourths  full,  and  with  a  good 
velocity.  A  12-inch  pipe  enters  from  the  west.  There  is  very  little  flow  in  this 
pipe,  and  it  is  three-fourths  full  of  mud'  and  gives  off  a  bad  odor.  This  manhole 
is  just  south  of  the  creek,  and  there  is  a  15-inch  overflow  into  the  creek.  A 
15-inch  iron  pipe  crossed  the  creek  and  continues  in  a  V.  C.  P.  to  the  river.  This 
line  has  been  described  elsewhere.  The  line  entering  from  the  west  is  in  a  very 
bad  condition. 

IS.  Manhole  at  Circle  and  Hawthorne  Sts.  Following  the  12-inch  line  back 
to  the  west.  This  line  is  in  very  bad  condition.  The  manhole  bottom^  are 
full  of  mud  to  the  middle  of  the  pipes.  The  line  branches  here,  ai  12-inch  line 
going  west,   and   another  of  the  same   size   to  south. 

93 


19.  Manhole  on  Cii-cle  Avenue.  There  is  lio  flow  here.  The  sludge  covers 
the  pipes  and  is   in  a  stagnant   condition.      Odor   is   very   bad. 

20.  Manhole  on  Circle  Avenue.  A  6-inch  V.  C.  P.  enters  from  the  south,  and 
a  12-inch  leaves  to  the  north.  The  flow  is  in  a  stagnant  condition,  and  the  odor 
is  very  bad.  Depth  to  water  surface  is  7.4  feet.  This  line  ends  with  a  lamp 
hole  on  Circle  and  the  Drive   Sts. 

Inspection    of   Jeflferson   Street   Outfall    Sewer. 

November    19,    1913. 

1.  This  sewer  empties  into  the  Kansas  River  directly  north  of  Jefferson 
Street.  The  sewer  is  a  44  x  56-inch  egg-shaped  brick.  A  concrete  apron  carries 
the   effluent   down   to   the  water   line  of   the   river. 

2.  Manhole  one  block  north  of  Crane  Street.  The  masonry  is  in  good  con- 
dition. The  depth  of  the  flow  is  one  foot.  A  16-inch  pipe  enters  from  the  Santa 
Fe  shops.  The  rate  of  flow  is  very  rapid.  There  are  house  connections  every 
twenty-five  feet  on  each  side.  Below  Crane  Street,  the  bottom  is  badly  silted, 
but  above  Crane,   the  bottom  is  clear. 

3.  The  manhole   at   Crane  Street   is   covered  up   and  was   not   opened. 

4.  Manhole  one-half  block  south  of  Crane  Street.  The  masonry  is  in  good 
condition,  the  rate  of  flow  is  very  rapid,  and  there  is  considerable  odor.  The 
depth  of  flow  is   8   inches. 

5.  Manhole  at  First  Street  is  covered  up   and  was  not  opened. 

6.  Manhole  one-half  block  south  of  first  Street.  Two  12-inch  laterals  enter 
here,  one  from  the  east  and  one  from  the  west.  There  is  S  inches  of  flow  in 
the  main  sewer.  The  rate  of  flow  is  very  rapid,  and  there  is  considerable  odor. 
The  crown  of  the  sewer  is  cracked  and  settled.  Also,  there  is  indication  of 
natural   gas  being  present. 

7.  Manhole  at  Third  Street.  The  rate  of  flow  is  very  rapid,  the  depth  of 
flow  is  seven  inches.  Two  12-inch  laterals  enter,  one  from  the  east  and  one 
from  the  west.  The  crack  in  the  crown  is  still  present,  and  the  odor  is  bad. 
There  is  considerable  seepage  of  ground  water,  and  the  bottom  is  quite  badly 
silted.      Masonry   is   in   good   condition. 

S.  Manhole  at  Fourth  Street.  A  10-inch  pipe  enters  here.  The  odor  is  bad. 
The  flow  is  very  rapid  and  ten  inches  deep.  The  sewage  is  very  heavy.  Sewer 
turns   east. 

9.  Manhole  at  Fourth  and  Adams  Sts.  Depth  of  flow  is  six  inches.  The  rate 
of  flow  is  very  rapid.  Masonry  is  in  good  condition,  and  the  odor  is  not  so  bad 
as  it  was  a  short   distance  back. 

10.  Manhole  100  feet  south  of  Fourth  Street.  The  depth  of  flow  is  six  and 
the  odor  is  bad.  12-inch  laterals  enter  from  the  east  and  west.  The  effluent  is 
rather  heavy,   and   the  velocity  is  good. 

11.  Manhole  at  Fifth  and  Adams  Sts.  The  masonry  is  in  good  condition, 
the  rate  of  flow  is  rapid,  but  the  odor  is  bad.  12-inch  lateral  enters  here  soine 
15  feet  south  of  the  inanhole.  A  reverse  curve  is  in  line  here,  with  a  manhole 
in  each  end  of  the  curve.  Depth  of  flow  is  9  inches.  The  size  of  the  sewer 
reduces.  Reduction  is  of  good  construction.  The  size  after  the  reduction  is 
54  x  40  inches.  100  feet  south  of  this,  a  12-inch  line  from  the  east  enters.  The 
flow  in  this  line   is  good. 

12.  Manhole  between  Fifth  and  Sixth  Sts.  Depth  of  flow  is  nine  inches, 
three  inches  of  sludge  in  the  bottom.  No  laterals  enter  here.  Rate  of  flow  is 
rapid,    and    there    is    considerable    odor.      Size,    54  x  40    inches. 

13.  No   manhole   on   Sixth   Street. 

14.  Manhole  between  Sixth  and  Seventh.  Depth  of  flow,  ten  Inches.  Rate 
of  flow   fairly   rapid.      An   IS-inch  lateral   enters  from  the  west. 

15.  Manhole  on  Seventh  and  Adams  Sts.  Depth  of  flow,  8  inches.  Rapid 
rate  of  flow  and  little  odor.  A  15-inch  line  enters  from  the  west.  There  is  a 
large  ainount  of  gravel  in  the  bottom  and  for  a  hundred  feet  south. 

94 


16.  Manhole  between  Seventh  ana  Eighth.  Bad  odor,  depth  of  flow  eleven 
inches,  rate  of  flow  very  rapid.  There  is  four  inches  of  gravel  in  the  bottom. 
A  15-inch  line  enters  from  the  west.  One-halt  block  south  of  this  the  sewer 
reduces   to  a   42  x  30-inch. 

17.  Manhole  one-half  block  south  of  Eighth.  There  is  seven  inches  of  flow, 
and  twelve  inches  of  mud  below  this.  Rate  of  flow  rapid.  A  12-inch  line  enters 
from   the  east,   and  a  16-inch   line   from   west. 

18.  Manhole  between  Ninth  and  Tenth.  A  15-inch  line  enters  from  the 
west.  Depth  of  flow  six  inches.  Rapid  rate.  Six  inches  of  sand  in  the  bottom. 
The   main   sewer   is  42  x  30    inches. 

19.  Outfall  of  overflow  into  the  creek  at  foot  of  Eleventh  Street.  This  sewer 
is  6x4%  feet,  egg-shaped  in  design,  and  in  good  condition.  Forty  feet  in  from 
the  outfall  is  the  overflow  dam  from  the  40-inch  sanitary  sewer.  This  dam  is 
32  inches  high.     The  condition  of  the  creek  at  this  outfall  is  bad — in  fact,   filthy. 

20.  Manhole  at  Thirteenth  Street,  between  Monroe  and  Quincy  Sts.  A 
40-inch  brick  sewer  in  good  condition.  Rate  of  flow  is  very  rapid  and  no  odor 
ia  apparent. 

21.  Manhole  on  Fifteenth  Street,  on  the  alley  beyond  Quincy  Street.  A 
15-inch  lateral  enters  from  the  north,  a  21-inch  V.  C.  F.  going  east.  There  is 
one-half    inch    of   flow   in    the   main    sewer.      Conditions    in    general    very    good. 

22.  Manhole  at  Monroe  and  Fifteenth  Street.  The  masonry  needs  attention. 
The  alignment  is  good.  A  15-inch  pipe  enters  from  the  north,  a  21-inch  from 
the   west,    and   the   main   line   east   is   24-inch. 

23.  Manhole  at  Fifteenth  Street,  just  beyond  the  Santa  Fe  tracks.  A  4ox  45- 
inch  egg-shaped  sewer.  The  odor  is  very  bad.  The  depth  of  flow  is  three 
inches  on  top  of  three  inches  of  sludge.  Masonry  is  in  good  condition.  No 
laterals   enter   here. 

24.  Manhole  beyond  Euclid  on  line  with  Monroe.  Manhole  cracked  on  top. 
The  bottom  is  badly  silted,  and  the  sewage  is  heavy.  Alignment  is  good.  There 
is  a  bad  crack  along  the  top  to  Eighteenth.  Four  inches  of  flow  and  three  inches 
of  silt.  An  S-inch  lateral  enters  below  the  water  line.  The  size  of  the  sewer  is 
45  X  40,    egg-shaped   brick. 

25.  Manhole  at  Quincy  and  Eighteenth  Sts.,  at  turn.  Four  inches  of  flow. 
Masonry   is   O.  K. 

26.  Manhole  on  Eighteenth  Street,  alley  one-half  block  east  of  Kansas. 
Flow  of  three  inches.  Four  inches  of  silt.  A  12-inch  V.  C.  P.  from,  the  north- 
west.    Alignment  is   good,  but  the   sewage   is  very  heavy. 

27.  Manhole  at  Eighteenth  and  Kansas  Avenue.  A  15-inch  V.  C.  P.  from  the 
side.  A  bad  crack  in  the  crown  of  the  sewer,  and  six  inches  of  sludge  in  the 
bottom. 

28.  Manhole  west  of  alley  on  Kansas  Avenue,  a  20-inch  line  from  the  north, 
and  a  20-inch  line  to  the  south.  Odor  is  bad,  but  the  velocity  is  good.  Depth 
of   flow   is   three   inches.     Seven   inches   of  sludge   in   the   bottora. 

29.  Two  manholes  on  Eighteenth  Street  and  Van  Buren  Street.  Masonry 
is  in  good  condition,  and  street  drains  enter  here.  No  reduction  in  size,  still 
45-inch. 

30.  Manhole  at  Eighteenth  at  alley  beyond  Van  Buren  Street.  A  52  x  40-inch 
egg-shaped  brick.  A  21-inch  V.  C.  P.  enters  from  the  south  side;  a  12-inch 
V.  G.  P.  enters  from  the  north.  These  lines  are  badly  stopped  up — in  fact,  the 
flow  is  less  than  two  inches,  while  there  is  12  inches  of  silt  in  the  bottom.  The 
alignment    here   is   good,    but   odor   is   very   bad. 

31.  Manhole  inlet  Harrison  and  Eighteenth  Sts.  Size  45  x  31  inches.  Twelve 
inches  of  mud;  two  inches  of  flow.  A  12-inch  V.  C.  P.  enters  from  the  south, 
and   there   are    four   surface    drains. 

32.  Manhole  east  of  Topeka  Avenue.  A  12 -inch  V.  C.  P.  from  the  west,  a 
30  X  24  from  the  north,  with  water  backing  up  in  it.  Eighteen  inches  of  water 
in  this.  A  12-inch  pipe  enters  from  the  west.  The  pipe  from  the  south  is  under 
the    water    line.      Bad    condition    in    general. 


33.  Manhole  at  alley  south  of  Eightteuth  Street.  A  27-inch  V.  C.  P.  with 
three       inches    of    flow.      No    noticeable    odor. 

34.  Manhole  west  of  Nineteenth  and  east  of  Topeka  Avenue.  No  slope  on 
the  benches.  A  12-inch  V.  C.  P.  from  the  west,  with  four  inches  of  flow  and 
two    inches    of    mud.      No    odor    and    good    masonry. 

35.  Manhole  west  of  Twentieth  and  on  the  alley.  A  curve  in  the  27-inch 
line.  The  sewage  is  clear,  with  five  inches  of  flow.  An  IS-inch  V.  C.  P.  enters 
from   the   south.     Flow  and  alignment   are   good. 

36.  Manhole  at  Topeka  Avenue  and  Twentieth  Sts.  and  Fair  Grounds.  A 
i!4-inch  enters,  and  a  27-inch  goes  out.  Three  inches  of  flow.  A  l.'i-inch  over- 
flow to  ditch,   and  a  12-inch  drain   from  the  northwest.      The   rate   of   flow   is   good. 

37.  Outfall  of  60  x  36-inch  concrete-lined  storm  sewer.  This  outfall  is  into 
Shunganunga  Creek.  There  is  very  little  flow.  Outfall  is  nine  feet  above  water. 
Good   alignment. 

38.  Manhole  at  Fillmore  and  Twentieth  Sts.  Made  of  concrete,  36  x  60-inch. 
An  IS-inch  dam  to  the  overflow.  There  is  three  inches  of  flow  and,  two  inches 
of  mud.  Concrete  line  is  36  x  30  to  the  north,  and  32  x  IS  to  the  south.  This 
manhole   has   been   repaired   quite   recently,    and   in    good   shape. 

39.  Manhole  at  Third  Street  and  alley,  between  Monroe  and  Madison.  The 
manhole  is  in  poor  condition,  and  odor  is  very  bad.  15-inch  V.  C.  P.  10-inch 
V.  C.  P.   from   the  southeast.      Depth   of   flow    is   one   inch. 

4  0.  Manhole  on  Second  Street,  between  Monroe  and  Madison.  Odor  very 
bad. 

41.  Manhole  between  Second  and  First  Sts.  The  odor  is  bad.  sludge  and 
mud  in  the  bottom,  slow  rate  of  flow.  A  bad  place  in  the  invert  here,  as  the 
bottom  is  entirely  covered  with  water.  Ladder  rusted  away,  and  the  masonry  in 
bad  shape. 

42.  Manhole  between  First  and  Crane  on  the  alley.  Sludge  in  the  bottom. 
The  odor  is   bad;   the   ladder   is   gone. 

43.  Msnhole  on  Crane  Street,  between  Monroe  and  Madison.  A  15-inch 
V.  C.  P.  The  odor  is  bad  and  the  veloctiy  is  slow.  A  15-inch  V.  C.  P.  from  the 
west.      Water   and   raw   sewage   stand   in   the    bottom.      Rotten    condition. 

44.  An  IS-inch  line  going  north.  Depth  of  flow  is  seven  inches.  Outlet  of 
sewi!r  between  Monroe  and  Madison.  A  20-inch  V.  C.  P.  Odor  is  bad  and  the 
rate   of   flow    is   slow. 

45.  0\itlpt    on    a    ]6-incb    V.  C    P.    with    one    inch    of    flow.       High    velocity. 

46.  Outfall  nuinber  2  a  22-inch  V.  C.  P.,  carrying  slaughter-house  refuse. 
Depth  of  flow  is  two  inches.  Effluent  stands  along  the  bank  in  a  stagnant  con- 
dition.     This   evidently    a   private    sewer   of    Packing   Company. 

47.  Manhole  on  Crane  between  Monroe  and  Quincy  Sts.  A  15-inch  V.  C.  P. 
There  is  two  inches  of  sludge  and  water.  An  IS-inch  V.  C.  P.  from  the  north- 
west.     Masonry    is    in    bad    condition.      The    odor    is    bad. 

48.  Manhole  on  Second  Street,  between  Monroe  and  Quincy  Sts.  Could  not 
open.      No    flow    and   the   odor   is   bad. 

49.  Inlet  manhole  on  north  side  of  Third,  between  Monroe  Street  and  Quincy 
Street.      Very    little    flow.      Septic    action    in    evidence. 

50.  Manhole  on  the  south  side  of  Third,  between  Monroe  and  Quincy  Sts. 
No  flow  and  septic  action   in   evidence. 

51.  Inlet  manhole  Third  and  Fourth.     No  flow  and  septic  action   in   evidence. 

52.  Manhole  between  Fourth  and  Fifth.  Rotten  condition.  No  flow  and 
septic   action    in   evidence. 

53.  Manhole  on  Crane  Street,  between  Quincy  and  Kansas  Avenue,  A  12- 
inch  V.  C.  P.  comes  in  from  the  northwest,  with  a  good  flow.  The  top  of  the 
manhole  is  skewed  over  to  allow  for  the  street-car  tracks.  Sewage  is  in  good 
condition. 

54.  Lamphole  on  Fourth  Street,  between  Quincy  and  Kansas  Avenue.  There 
is   a   bad   odor  here,    and   a   rapid   rate   of  flow. 

96 


55.  Manhole  Fourth  Street,  between  Qulncy  and  Kansas.  IS-inch  V.  C.  P. 
going  out  north,  and  a  15-inch  Y.  C.  P.  conriing  in  from  the  south.  Depth  of 
flow  is  one  inch.  8-inch  drain  froni  the  west.  Manhole  is  in  fair  condition,  but 
needs  a  new  cover. 

56.  Manhole  at  io,£-  between  Sixth  and  Seventh  and  between  Ouincy  and 
Kansas.      12-inrh  V    C.  P.      Depth    of  flow   is   2-inches.      Good  rate   of  flow, 

57.  Manhole  Eighth  Street,  between  Quincy  and  Kansas.  12-inch  V.  C.  P. 
There  is  one  inch   of  flow  here,   and  five  inches  of  mud.     Flow  has   good  velocity. 

5S.  Manhole  at  log  between  Eighth  and  Ninth  Sts.  There  is  a  good  flow 
here.      There   is    a   steam   pipe   intercepting   the   manhole. 

59.  Manhole  at  Ninth  Street,  between  Quincy  and  Kansas.  There  is  a  good 
rate  of  flow  here.      1.5    inches  of  flow. 

60.  Manhole  at  .iog  between  Ninth  and  Tenth,  between  Kansas  and  Quincy. 
There    is   a   slow   velocity   here.      There   is   1.5    inches   flo^v. 

61.  Lamphole   near   Tenth   Street   in   the  alley  between   Quincy   and   Kansas. 

Lnspeotinn   of   Flnsh   Tanks. 

1.  On  The  north  side  of  Huntoon.  between  Buchanan  and  Lincoln  Sts..  the 
water  was  running  freelj-,  but  not  filling  the  tank.  This  was  probably  due  to  a 
leak  in  the  siphon. 

2.  On  the  north  side  nf  Huntoon  between  Lincoln  and  Lane,  the  valves 
broken  and  bell  of  siphon  gone.  The  water  flowing  directly  into  the  sewer  in  a 
steady    stream. 

3.  On  the  south  side  of  Euclid  Avenue,  in  the  alley  between  Lane  and  West 
Sts.,  tank  is  in  good  condition.  Diameter  of  the  tank  44  inches.  Depth  at  which 
it  flushes,    24   inches.      Flushes   at   intervals  of   36   minutes. 

4.  On  the  south  side  of  Euclid  Avenue,  between  Clay  and  Buchanan,  tank 
is    in    good    condition.      Same    size    as    No.    3.      Flushes    at    intervals    of    30    minutes. 

Xorth  Topeka  riush-Tanks. 

1.  On  Saywell  Avenue,  and  alley  we.st  of  Kansas  Avenue,  tank  stands  full 
of   water.      No  flow   in   or   out. 

2.  North  of  the  I'nion  Pacific  Station  and  one-half  block  east  of  Kansas 
Avenue,  tank  is  in  good  order.  The  dimensions:  4  feet  sQuare:  depth  of  flush, 
21    inches.      Flushes    at    20    minute    intervals. 

(These   are  all  the  flush-tanks  found   and  inspected.) 


97 


APPENDIX  "E' 


MILK  PEODUCERS  ACCORDING  TO   AMOUNT   PRODUCED, 

TOPEKA,  1913. 

(Figures  furnislied  by  City  Milk  Inspector.) 


Producing- 

Average 

Average 

Number  of 

dally 

qts.  per  day 

producers 

Per  cent 

qts.  produced 

Per  cent 

0—  25 

63 

35.6 

931 

10.3 

26—   50 

57 

32.2 

2152 

23.6 

51 — 100 

37 

20.9 

2584 

28.4 

101 — 150 

13 

7.3 

1631 

11.9 

151 — 200 

1 

0.6 

160 

l.S 

201    and    over 

6 

3.4 

1640 

IS.O 

Totals 

177 

100.0 

909S 

100.0 

CHEMICAL  EXAMINATIONS  OF  TOPEKA  MILK,  NOV.,   1913. 
(ExamiBations  at  State  Agricultural  College.) 


Dairy 

Butter  Fat 

Total  solids 

Daily 

Butter  Fat 

Total  solids 

1 

•      3.50 

12.27 

15 

4.10 

13.16 

2 

4.10 

12.28 

16 

4.20 

12.80 

3 

4.20 

3  3.36 

17 

4.05 

12. S3 

4 

3.50 

12.58 

IS 

3.40 

11.91 

5 

4.10 

13.20 

19 

4.05 

13.20 

6 

3.90 

12.56 

20 

4.20 

li'.yij 

7 

4.05 

13.21 

21 

4.10 

13.10 

8 

3.40 

12.50 

99 

4.30 

13.40 

9 

4.10 

13.18 

23 

4.05 

]2.2S 

10 

3. SO 

12.60 

24 

4.15 

12. SO 

11 

4.00 

13. IS 

25 

4.00 

12.18 

12 

4.30 

13.20 

26 

4.05 

12.60 

13 

3.S0 

12.51 

27 

3.40 

11.16 

14 

4.40 

13.73 

MAIL  PRINTING  HOUSE.  TOPEKA.    KS 


98 


COLUMBIA   UNIVERSITY   LIBRARIES 

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C28(B46)M25 

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^-i^S  sch52 

Schneider 
A  public  health  survey  of  Topeka 


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